Abstract
We have discussed the future development psychosomatic medicine in Japan from the standpoint of psychiatry with the focus on its academic base, clinical practice, education and research. With the basic change of the academic concept of psychiatry due to DSM-III from nosological entity to clinical entity, it becomes necessary to clarify more the image of psychosomatic medicine as compared to psychiatry. In clinical practice, it becomes more important to share the standpoint of psychiatry ; i.e. physical symptoms mainly at the Psychosomatic clinic, mental symptoms mainly in at the Psychiatry clinic, for patients suffering from anxiety, somatoform, eating, sleep, and mood disorders. Especially patients suffering from mild, masked, involutional and/or panic type of depression are much popular at the Psychosomatic clinic. Therefore the psychosomatist must receive adequate training for prevention of suicide. On the other hand, the psychiatrist must receive adequate training for psychosomatic practice, because psychosomatic education in Japanese medical schools and universities is quite inadequate at the present time. Establishment of the system for the specialists of psychosomatic medicine is the most expected assignment in Japan. And establishment of Department of Psychosomatic Medicine at all medical schools and universities in Japan is also very highly expected in the near future. Recent remarkable development of biological psychiatry utiliging neuro-imaging, gene technology etc. such as functional MRI, PET would present many resources for proceeding to the progress of psychosomatic medical researches ; i.e. intracerebral mechanism based on neurogenesis of psychosomatic correlation in the brain, mechanism of psychoneuroendocrinoimmunomodulation, selection of organs and/or individuals, tolerance against stressful situation. On the other hand, the concept of the bio-psycho-socio-ethico-ecological model in Psychosomatic Medicine would present a humanistic existential research in psychiatry. Progress of psychosomatic research of health promotion (salutogenesis) will contribute to the longevity in human being.
