There has been no systematic research study on behavioral therapy in the treatment of dental psychosomatic disorders. The author has been involved in the diagnosis and treatment of oral psychosomatic diseases for the past 15 years at Tokyo Medical College and, using the opportunity of the President's Presentation, discusses the general concepts involved today in the behavioral therapy of various dental psychosomatic diseases. The history of behavioral therapy is traced, a classification of psychosomatic diseases is presented, pathological conditions for which behavioral therapy is indicated are described in order to give a complete overview of the clinical picture of this modality and several classical cases from the author's experience are presented. Deep seated fear of dental treatment is common and the problem of bad habits is one that occupies a uniquely prominent position in the field of dentistry. Behavioral therapy is the most ideal modality for these conditions and, as it holds unlimited potential for the treatment of dental psychosomatic diseases, its future is extremely bright.

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悪性腫瘍に起因する痛みは困難であり,心理的葛藤な問題が屡々みられる。われわれは20例の痛みをもつ末期症患者に心理テストを用いた。患者を葛藤と心理機制の度合によって3群に分けることが出来た。そのうちグループ(2)グループ(3)の症例は不安が強く,抑うつ的であり,心理的適応の困難がある。そこでわれわれはこのような症例には気分を昂揚させるような精神療法を行ない,成功している。次に悪性疼痛に関連した術後慢性疼痛患者の2例を紹介する。眼窩部および測頭部痛であり,第1例は術前から不安が高く,性格も未熟で,夫に強く依存していた。第2例は医師が痛みの原因をくわしく説明したことが明らかになった。これらの症例に筋弛緩法や筋電図バイオフィードバック療法,精神療法を行なって改善した。

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The most complaints of the out-patients at the ambulant dental and oral clinicsa re related to pain. Above all, more than 80-90% of the complaints are dental pain. The rest of the complaints are pain induced by inflammations, infections and tumors in the oral and maxillofacial area, and uncertain pain with unclear organic causes. Behavior therapy has become more popular in the clinics of various medical fields recently, and the reported cases are mostly concerning with special cases, and studies on the behavior therapy applied on ordinal cases are little known. The same is true for the treatment of pain except the case of psychosomatic diseases, or neurosis, with very limited symptoms. The author thinks that the behavior therapy should be applied on wider area of clnical cases, and the behavior therapy must be applied in practically routine clinical cases. "Pain" is still a black box, although many studies have been devoted to clarify the cause and etiology. Behavior therapy has been applied for the treatment of pain, and the author also has devoted to do so. Quantitative evaluation of pain is impossible, and the pain is only evaluated by the subjective expression of "pain". The difficulty of the evaluation of the therapeutic effect lies here. The author will present application reports on the removal of the symptom, pain, mitigation and control of pain in the daily clinical practice.

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本研究の目的は末梢血管運動反応に及ぼす運動反応と筋弛緩の制止効果を検討することである。実験1では,30名の大学生被験者のうちの半数が,右手の開閉を続ける運動反応に割当てられた,一方,残りの半数は処置をしない統制群となった。運動反応は光刺激に対する血管運動反応の減少を引き起こした。実験2では,18名の大学生被験者のうち9名が実験群として筋弛緩訓練を受けた,そして,残りの9名は統制群として処置を受けなかった。両群は,最大血管収縮に関しては類似していたが,回復時間では著しく異っていた。筋弛緩と運動反応の両群で,回復時間に有意な差がみられなかった。結果は,運動反応による拮抗動作法が恐怖症の効果的な治療法であることを示唆した。

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