The authors applied TPI to the normals and psychiatric patients, and studied (1) the mean values of standard scores (T scores) on the validity scales, clinical scales and additional scale of TPI, (2) the degree of ratio of the normals and psychiatric patients through the discriminating indexes, and (3) the frequency and features of the two-point codes. The results were as follows : (1) On the validity scales, clinical scales and additional scale, the mean values of T scores of the normals were within the normal range of 45〜54 points. Compared with those of the normals, the mean values of T scores of the psychiatric patients were generally higher on any of the clinical scales. But there were found few clinical scales which showed abnormal scores, except in the case of some neurosis. With each kind of disease, such applicable scales as are considered to have some relation to the status of the disease showed higher scores than other scales. On the validity scales, T scores of Rr and Uf showed expressively higher values as compared with the normals. (2) According to the discriminating indexes on the clinical scales, 8.4% of the normals, 74.0% of the neurotics, 44.4% of the borderline cases, 70.0% of the depressives, 67.3% of schizophrenics, 57.1% of the atypical psychotics, 56.7% of the epileptics and 33.3% of the school refusals got T scores of 70 or more on one or more scales. In clinical classifications of neurosis, 76.9% of the hypochondriacs, 77.1% of the anxiety neurotics, 100.0% of the obsessivecompulsive neurotics, 58.3% of hysterics, 66.7% of the phobics and 70.6% of the other kind of neurotics got T score of 70 or more on one or more scales. (3) As for the types of two-point codes, such types as (2・4,4・2), (1・4,4・1), (1・2,2・1), (2・3,3・2) and (5・6,6・5), which frequently happened with the patients, were considered as the codes which have high possibility to indicate abnormality. With each kind of psychiatric disease, there was found a high frequency of such types of codes as are in combination with its applicable number which shows the disease. The frequencies of other types of codes were considered to have some relation to the status of the disease. With epilepsy, however, there were found no such type of codes as having its applicable number at their first places, while there were found a lot of such types of codes as having, 5,6,3 and 4 at their first places.

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In order to inverstigate the clinical importance of sleep disturbance in the etiology of petic ulcer, the authors conducted a comparative study of the incidence of peptic ulcer among laborers who are now on the night-shift, previous shift-laborers and daytime laborers. Of the abnormal examinees found by mass x-ray examination of upper GI tract, the precise x-ray and endoscopic examinations were performed to establish the diagnosis of gastic or duodenal ulcer. The subjects (N=6397) of the present study all belonged to the institution where the authors conducted the second examinations. Of these subjects, gastric ulcer was found in 99,its scar in 67,duodenal ulcer in 71 and its scar in 66. The toltal namber of peptic ulcer thus diagnosed amounted to 303 cases. With the present time shift-laborers (N=1073), the incidence of gastic ulcer was 2.6% (N=28), and that of duodenal ulcer was 1.95% (N=21). In the previous shift-laborers (N=1011), the incidence of gastric ulcer was 1097% (N=20) and that of duodenal ulcer was 0.59% (N=6). To the contrary, in the daytime laborers (N=3564), the incidence of gastric ulcer was 1.29% (N=46%) and that of duodenal ulcer was 0.29% (N=33). The work-system of 749 examiness was unknown. Thus among shift-laborers, the incidence of gastric and duodenal ulcer was higher than that in daytime laborers. The statistical significaces were verfied by the chi spuare test (both p<0.01). This study showed that the shift-work, which was accompapained by sleep disturbance, played an role in the etiology of peptic ulcer.

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Thirty patients with eating disorder were classified into 3 groups : 1) anorexia nervosa, 2) dysorexia nervosa and 3) simple obesity groups. Nine patints belonged to the anorexia nervosa group, which was characterized by only anorexia, weight loss of more than 20% from ideal body weight and amenorrhea. Eleven patients belonged to the dysorexia nervosa group who had not only the anorexic phase but the polyphagic phase. Ten patients belonged to the simple obesity group who showed the weight gain of more than 20% from ideal body weight. Growth hormone secretions after oral glucose loads were studied in the three groups. The results were as follows : 1) Paradoxical rises of grouth hormone after oral glucose loads were found in 4 out of 11 patients with dysorexia nervosa, which is of high frequency compared with anorexia nervosa and simple obesity. These results suggest that patients with dysorexia nervosa may have some dysfunction in the satiety center of the hypothalamus. 2) Growth homone suppressions after oral glucose loads were found in 9 out of 10 patients with simple obesity. 3) The basal value of growth homone in patients with anorexia nervosa and dysorexia nervosa was signficantly higher than that in patients with simple obesity.

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The personality characterisics of the patients with anorexia nervosa and their mothers were ascertained using personality tests, including CMI, MAS, MMPI, and the PF study. The patients showed a noeurontic tendency, high anxiety, strong dependence, low aggressiveness and overrationalization of conflicts, whereas their mothers showed excessive feeling of expiation, lack of aggressiveness and inferiority in their ability to settle thier problems. Between the patients and their mothers were significant correlations of some personality traits such as vulnerability to various complaints, sensitiveness, high anxiety, teision, strong dependence, low aggressiveness and repression. Thus, it was suggested that the disturbed ego identity in anorexia nervosa patients may results from their difficulty in identifying with their mothers' personality characteristics.

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Development of bronchial asthma is usually attributed to hypersensitivity of the respiratory tract, allergic factors and infection, but psychogenic factors have no less importance in that development. We experienced one case of bronchial asthma in which psychogenic factors played an important role. The patients was treated with psychotropic drugs only to be complicated by lowering of PaO2 and atelectasis. The patient was a 71-years-old woman who had been treated by a home doctor under the diagnosis of bronchial asthma since 1971. In March 1979,she had visited our hospital because of dyspnea, vomiting and depressive state, which were improved by interviews. In April 1980,dyspnea and depressive state recurred, when she was readmitted and given antidepressants, which brought about atelectasis on the left lung. As she had a temporary improvement, she was transferred to another hospital where she was continuously treated with anti-anxiety drugs and antidepressants only to have redeveloped atelectasis. Atelectasis at the left lower lobe still remains uncured. Psychotropic drugs are useful for bronchial asthma, but they should be administered very carefully with due consideration to the time of administration. Supplementary drugs need to be used in combination with them by paying careful attention to their dosage.

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An epidemiological study was made of 81 patients with mild hypertension by using the Japan Productivity Center Mental Health Inventory (JMI) among male workers. They were divided into groups. The group of hypertensives (Psychosomatic disease-PSD) (27 cased) were separated, by interviews, from the other group (54 cases) according to the standard as defined by the Japanese Society of Psychosomatic Medicine. JMI consists of the four categories, that is, body, mental abnormality, and occupational adjustment. First, the hypertensives as a whole (81 cases) reported less levels of the body scales, including stomach, nervous system, fatigue and irregularity of daily life than the control. Regarding the mental abnormality scales, high scores were found in pre-melancholic, hyperthymic, cohesive tendencies and alcohol addiction, and low scores in hebephrenic, weak-willed qualities. They recorded also high scores on the personality scales of extraversion, control of emotion, spontaneity, goal-attainment, empathy and adaptation. On the occupational adjustment scales, they showed strong confidence in work, while the relations with supervisor were not good. Second, the hypertensives (PSD) were compared with the remaining group. We found that the scores of many physical symptoms and fatigue were high in the hypertensives (PSD). Scores in schizothymic, suggestible, obsessive-compulsive, hypochondriacal, anxiety, unstable, weak-willed tendencies and alcohl addiction were high in their mental abnormality profile. On the personality scales, low control of emotion and high flexibility were found. Their relations with colleagues were poor, and their prospects to the future were not optimistic as far their occupational adjustment was concerned. These results indicate that the profiles in hypertensive (PSD) are very similar to those of neurosis. In contrast, the others have a tendency to alexithymia, and their profile of each scale is similar to those of a Type A behavior pattern. Thus, the existence of two psychological types of mild hypertensives was suggested.

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Microvibration (MV) patterns of 261 inpatients were studied. MV was measured on the left thenar eminence in the supine position within one month after admission to our psychosomatic ward. Then MV patterns were classified into 4 types (N, S, F, I) according to the Kuroki's criteria. The correlation between MV patterns and diagnoses, and that between MV patterns and chief complaints were studied. The resulys obtained were as follows; 1. 145 cases (56%) showed the N type, 12 cases (5%) the S type, 92 cases (35%) the F type and 12 cases (5%) the I type. Compared with Kuroki's normal group, the F type was remarkably increased in these patients. 2. The F type was markedly increased in Anorexia Norvosa. In Hypertention, the S type and the I type were increased. 3. The increase of the F type in the patients who complained emaciation or anorexia was probably influenced by the diseases from which they suffered. 4. We think it necessary to study MV patterns in the patients with similar disease states.

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As chronic algogenic diseases in the oral cavity increase recently, we sometimes have difficulty in diagnosis and treatment of the patient, and same is true with glossodynia. In order to understand glossodynia and to establish a therapeutic method, we have been examining the patient from the view point of its psychosomatic characteristics. There was no organic change in the tongue in glossodynia, and no abnormality in the physical examinations and laboratory tests, but still the patients has pain. The disease condition should be examined on the psychogenic bases. In order to examine the relation between glossodynia and its psychogenic cause, an inquiry format of CMI, YG and SRQ-D, examination of the autonomic nervous system dysfunction, examination of the autonomic nervous function with microvibration technique were performed, and the psychosomatic characteristics of glossodynia observed during the couse of therapy will be reported. Psychotic tendency was examined by CMI : that is, psychotic tendency was more effectively improved in the patients showing better therapeutic results, and such results are one of the notable characteristics. The emotional tendency examined by the YG test showed no marked improvement as in the psychotic tendency, but some individual cases showed considerable correlations, so that we should give a case attention. Examination of depressive tendency using SRQ-D method showed better improvement in the patients showing better therapeutic effect. These are interesting correlations. Examination using microvibration showed also better improvement in the autonomic nervous function in the patients showing better thetrapeutic effect. As shown above, degree of glossodynia, therapeutic effect and laboratory tests were well correlated when the degree of glossodynia was more severe, so that characterisitics and changes of psychosomatic factors should be taken into consideration for the therapeutic process.

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The following 2 cases of vision impairment were determined to be psychosomatic in nature. Analysis of their premorbid conditions, ensuing symptoms, and amelioration has contemplative value in terms of psychosomatic diagnosis and treatment. The first case, a male, aged 22,who had been hospitalized for convulsive attacks, was engaged in secret gambling with other sickward patients. Subsequently, he fell in dept and experienced blindness the next day. Psychotherapeutic attempts followed but were found abortive. Abatement in symptoms came about several months later, as the patients developed affections for a female inpatient. The second case, a female, aged 17,had been admitted for ptosis of the eyelids. She also came from a family having discord over her father's gambling debts. As in the previous case, psychotherepy was ineffectual. Symptom abatement occurred through establishing a liasion with a male inpatients. Although symptoms in both cases were different, effects in vision impairment were commonly shared. Discussion of such symptoms is made with the following cbservation : 1) Both cases featured incidences of dependency, passivity, and hypersensitivity related to interpersonal relationships, as well as engagement in attention-gettiong. The experience of shame from exposure to such weakness led to emotional suppression. 2) Such suppression made a predesposition to psychosomatic incitements whenever enormous difficulties were encountered. 3) Symptoms of vision impairment seemingly offer convenience whenever coping is difficult, as awareness and its concomitant anxiety is apparently avoided. 4) Non-rerval modes of therapy appeared to be superior to verbal ones, at least, in the earlier stages of treatment.

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