The relationships between field dependence and pain threshold and tolerance under thermal pain, and pain estimation and changes of heart rate under cold pressor pain were investigated with ninety-one surgical patients admitted into the National Cancer Center Hospital. Subjects were subdivided into three groups according to their scores of EFT.Results : 1. No significant relation was found between field dependence and age.2. FDs showed significantly higher pain threshold than FIs.3. With regard to cold pressor pain, FIs were most sensitive in estimating pain, and showed greatest heart rate changes.4. Positive correlation was found between EFT and Block Design test as previously reported.5. FDs showed significantly higher trait anxiety (STAI) than did the other two groups.Above mentioned results suggested that perceptual style was a new and important dimension to understanding of experimental pain, and that further psychosomatic investigation had to be made.

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The evidences that the psychological factors influenced the prognosis of allergic diseases were observed by many clinicians and suggested the correlationship between stress and the immune system. To clarify the correlation more in detail, the authors had carried out animal experiments whose results showed the affection of stress on plasminic activity, on Hageman's activity and cytotoxicity of killer T cells. In this paper, these studies were succeeded to the influence of stress on the function of macrophages, which had important roles in the immune system such as phagocytosis, recognition of antigen, etc. By using mice (AKR), the carbon clearance method was carried out to measure the activity of phagocytosis of macrophages. Stresses were given by immobilization and by the stress box where the stimuli of electricity, light and buzzer were given. Changes of the activity of phagocytosis were observed at the different durations of stress. The results showed that in the stress box group, the carbon clearance rates had been depressed during two to five days of stress, but at the sixth day, carbon clearance rates were rather recovered due to acclimatization of the mice to stress. In the immobilization group, the activity of phagocytosis was rather enhanced by stress until the eighth hour and then was suppressed strongly. Suppression of the function of macrophages was nor recovered by infusion of the serum of control mouse. Corinebacterium can inhibit the suppression of phagocytosis by stress. Our experiments suggested that stress affected the phabocytic function of macrophage directly not through the serum factors.

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When carrying out a biochemical study on depression it is essential to investigate amine metabolism as well as its related enzymes in depressive patients. In his study the author presented the findings on the change of urine catecholamine and serum DβH-inhibitor in endogenous depression and intended to clarify their pathogenetic significance.The subjects were 34 cases of endogenous depressive patients. The author developed a new technique for measuring urine catecholamine and serum DβH-inhibitor. The former was done using native flourescence liquid chromatography systems and the latter, by spectrum photometry.It was discovered that the concentration values of urine catecholamine in depressive patients were lower than those of the control group and there was a negative correlation between the urinary noradrenaline level and Hamilton Rating Score. Compared with the control group, significantly higher levels of DβH-inhibitor were observed in the depressive patient group.In this findings, the author reported that DβH-inhibitor acted as a kind of contrl for noradrenaline biosynthesis which was significant for the pathogenesis of a depressive state. They postulate the important role of understanding the noradrenaline theory of endogenous depression.

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Object : The object of this trial is to establish a method of biofeedback therapy on asthmatic patients.Method : Biofeedback therapy (BFT) was tried on 3 asthmatic patients. The instruments used were Biological Sound Monitor (BSM Tiep) and Respiratory Resistence Meter (RrM : Nihon-koden).We applied 2 kinds of BSM for 30 minutes, one was S-method that amplified the sound volume of wheezing, and another was T-method that generated "P" sound when the wheezing exceeded the threshold. These methods were on auditory sense information. Instructions were set as followed : on S-method, "Weeken your wheezing", and on T-method, "Decrease your "P" sounds numbers each 5 minutes."When RrM was used (10 minutes), there were on informations of sense of sight, and instructions were set as followed : "Decrease your Rr level and keep it low graduation".Results : 1) BSM-S-method; On 2 cases, wheezing were lost, on 1 case it became weeker after BFT.2) BSM-T-method; On 2 cases, the number of "P" sounds decreased, 1 case showed no change.3) Improvement of Rr after BFT of BSM; i) Immediately after, there were hardly any change.ii) 1 minute after, there were significant lower Rr than before BFT.iii) 2 minutes after, there were lower Rr level than 1 minute after.iv) 3 minutes after, these were equal to that of 2 minutes after Rr.4) Rr meter method; i) There was nor emarkable improvement by one-time training.ii) There was significant improvement from the operant level by 51-60 time training.Conclusion : It is expected that biofeedback therapy can be effective for a decrease of Rr level and a symptomatic improvement of asthmatic patients.

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The aim of the present investigation was to study plasma gonadotropin secretion after infusion of LH-RH. The subjects were postmenopausal depressed women after hysterectomy seen in internal medical clinics. Psychological tests and an autonomic function test using microvibration were carried out. It was suggested that hysterectomy in climacterium was important as a risk to cause depression. We therefore made literature surveys of hysterectomy and depression. It was found through endocrinological data that plasma LH concentration in primary depression was less than that in the contrl and in secondary depression. However, plasma FSH concentration showed no significant differences between 3 groups (control, primary depression and secondary depression). Plasma LH concentration in LH-RH test revealed high responses in the order of primary depression, control and secondary depression. However, plasma FSH showed no significant differences between 3 groups. The mean of LH concentration after LH-RH in 5 primary depression revealed hypo-poor response, and the mean of LH in secondary depression revealed hyper-well response.When comparisons were made between the anxiety type and the retarded type in clinical features of depression, gonadotropin response in LH-RH revealed no significant differences between primary depression and secondary depression. All patients with the retarded type of depression were classified under primary depression.Comparisons among psychological tests revealed that V items and M-R items of CMI and MAS scores had no significant difference. However, SRQ-D in primary depression increased significantly than in secondary depression. Plasma gonadotropin secretion was little affected by hysterectomy. The change of LH and FSH secretion might be influenced by affective disorders.

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In today'ssociety, it is not uncommon that deviate family patterns create various mental illnesses. Psychosomatic diseases constitute one example of the diseases induced by these phenomena. The author studied the family types in which a family member had been diagnosed as borderline-psychosomatic. From the study it was discovered that families with a boderline-psychosomatic patient could be classified into 3 general categories : (1) obsessiveness, (2) over-protectiveness, and (3) separation and anxiety. Generally speaking, the specific actions of a family exhibiting any of the aforementioned characteristics would produce an individual with psychosomatic symptoms. The author, first of all, examined the family dynamics of typical cases and then explained the process causing the appearence of symptoms and introduced the appropriate therapy. In addition, the author touched briefly on psychotherapy for a family with a boderline-psychosomatic patient and discussed step by step how to couduct a survey on these families; how to conduct psychotherapy effective to both the patient and family; and how to integrate all relevant pieces of information. The author hopes to confirm this method further by increasing the number of such case studies in the future.

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The paper of Chisholm et al. (1978) reported that newborn irritability assessed with the Brazelton Scale was related to maternal blood pressure during pregnancy. This irritability, among behavioral characteristics, is recognized as one of the most important factors that have a significant influence on infant-environment interactions in the course of its development. In order to explore the relationships between some perinatal factors, including maternal blood pressure, and newborn behavior, the present study was designed to investigate whether newborn behavior assessed on the basis of the state change during the sucking experiment of a tube-like nipple had any relationship with the perinatal factors represented in terms of perinatal risk scores and maternal blood pressure. The results obtained are as follows : (1) there was a statistically significant negative correlation of perinatal risk scores with the scores of "adaptation", one of the three behavioral patterns designated as such by us on the factor analytic basis; and (2) there was a statistically significant negative correlation between the maximum M.A.P. (Mean Arterial Pressure) in the 2nd trimester during pregnancy and the frequency of state change, and a statistically significant positive correlation between the maximum M.A.P. in teh 2nd trimester and the scores of "adaptation" mentioned above. From these findings it is suggested that maternal blood pressure, not to speak of perinatal risk factors, may exert some influence on newborn behavior such as irritability even in the different directions, that is, not only in negative as Chisholm et al. mentioned but also positive ways.

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Abnormal mental states of the CCU patients exert some negative influence upon cardiac intensive therapies in a CCU. Therefore, it is quite important for the CCU staff to understand mental states of the patients in order to offer accurate care to them.A psychiatric intervention was started on the CCU patients in the Nippon Medical School Hospital in May, 1978,as a part of our activities in consultation-liaison psychiatry programs.A research was conducted with the patients suffering from acute myocardial infarction(AMI) from September 1,1979 to August 31,1980 regarding their mental states.Of 135 AMI patients admitted to our CCU from September 1,1979 to August 31,1980,105 patients, 75 males and 30 females, ages from 29 to 84 were studied.Diagnostic procedure of mental states included psychiatric interviews and psychological tests (YG, MAS, JMI, Hasegawa DR Scale) during patient's stay in the CCU. Through these examinations, 105 patients with AMI were classified as follows : 37 patients were in anxiety states, 15 in depressive states, 9 in manic states, 9 in demented states, 2 with problematic behaviour, 1 in a hypochondriacal state, 1 in a postcardiotomy delirium-like state, 1 in a delirious state (nocturnal delirium), and 30 others in normal states.The purposes of this report are to elucidate the mental states of patients with AMI in the CCU and to classify mental states and case-histories of these CCU patients.It is emphasized that psychiatric intervention should be available in order to carry out adequate cardiac treatment for the AMI patients in the CCU.

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Recently, it is said that there are many psychosomatic diseases and neuroses in the industrial society, but epidemiological data concerning these diseases are scarce. In order to meet this need, we, the Mental Health Research Committee, have developed the Japan Productivity Center Mental Health Inventory (JMI). The new inventory system cen contribute to better assessment of mental health and thereby aid the further development of preventative methods against mental disorders. The four categories, that is body, abnormality, personality and occupational adjustment are the basic components of JMI.In the present study, the validity of JMI was tested by two stepwise discriminant analyses. One analysis was made between 25 essential hypertension patients and 80 samples randomly selected from those who did not say "yes" to psychosomatic disease check list which was given to 12,009 working persons. The total rate of correct diagnosis is as high as 100.0% at the 16 th step, and 98.1% at the 5 th step. The other analysis was made between 37 heart neurosis patients and the 80 same samples as above. The total rate of correct diagnosis is as high as 100.0% at the 33 rd step, and 96.6% at the 8 th step.The validity of JMI was examined from another angle. The essential hypertension profile of each score is very much a like to the profile of those who are prone to heart disease, called a Type A behavior pattern. The Type A characteristics are equivalent to some of the JMI scales : these scales are goal-attainment, attention-seeking, motivation to work, spontaneity, version, hypochondriacal trend, and empathy. Scores in all scales are on the significantly high level.Heart neurosis's scores indicate the highest level in the cardiovascular system. Scores in anxiety, hypochondriacal, obsessive-compulsive, attention-seeking and pre-melancholic scales are significantly high; on the other hand, hypomanic is significantly low.These results correspond to Ishikawa's classification of 5 types of heart neurosis according to mental states.These analyses show the validity of JMI in that it could discriminate essential hypertension and heart neurosis among from many workers.

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[in Japanese]

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The patient was a 10-year and 11-month-old girl who had been hospitalized in five different hospitals for repeated violent abdominal pain and vomiting over a 15-month period.A team approach to her by a psychiatrist and a medical social worker proved to be effective. While arranging the patient's environment by house calls and visits to her school, the social worker played a maternal role supplementing the psychiatrist's approach which was paternal and therapeutic representing"reality". Her family began to grasp her symptoms as a problem of the whole family and appropriately cope with her symptoms. In her relation to the social worker, the patient herself became able to verbalize various sores of her heart which would had been attributable to her parents' divorce, and to be conscious of events which became a trigger for somatization. After voluntary discharge she continued to meet the physician who was representing the outside world, the society, with the social worker as her support. About one year after the therapy, episodes of abdominal pain and vomiting disappeared, her group adaptation became satisfactory, and the rate of school attendance improved to be almost 100%. In this case, the social worker attempted to contact the patient's environment and gave an indirect aid to the physician's treatment. In addition, she also played a therapeutic role in the reciprocal relationship with the physician. To handle efficiently the effect of group dynamics of therapeutic team remains to be a target in psychosomatic medicine.

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