In this paper, the authors attempt to investigate the chracteristic disturbance of development of sexual identity in patients with anorexia nervosa, by comparing with normal females. This study included how to get clues to this status. The Subject group consisted of 12 females who were under medical treatment as anorexia nervosa. The control group (12 females) had standard body weight, regular menstruation and normal attitude and conceptions toward food and body image. Two Subject groups were corresponded each other as to age (12-24) and school carrier. In the Rorschach test, normal subjects revealed dependency and aggression along with objectivity. On the other hand, the patient group showed a tendency to show the conflict figures of oral aggression coexisting with dependency with no integration. The interview of their life history indicated as follows : The normal subjects recognized their own somatic sexual changes as natural phenomenon of their own self, so that they might look for their own way of life through the relationship with their mother, friends and men. This is the natural plot of development in one's individual sexual identity. But the patient group is obstructed in the establishment of mother-child relationship in their adolescence, and therefore decathexis from their mother was more disturbed. This Seemed to be the reason why they failed in the establishment of their sexual identity.

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Successful treatmerlt of facial defect patients using an epithetic appliance requires the dentist to pay attention to their physical, biological, and psychological problems. The psychological factors are especially important in Japan. Embarassment is pointed out by many patients as a large factor in rejecting use of an epithesis. These psychological factors are not found in the reports from American and European colleagues. In this study, we compaired some psychological factors in two cases of facial defect patients (Fig. 1 and Tab. 1). Case 1 has been wearing an epithetic appliance for 15 years, while Case 2 rejected use of it. Through evaluating these patients. it became clear that whether or not the patient was self-independent was a very important factor affecting his attitude towards epithesis acceptance. This study was initiated to detemine prospectively whether there was a relationship in facial defect patients between psychological elements and epithesis acceptance. Three assessing methods were employed prior to the treatment, namely YG personality test, MMPI and an interview based on our original protocol. The result of the YG tesd dshowed that the D type patient had a high probability wearing an epithesis (Tab. 2), It was also suggeded that the personality of an epithesis wearer was inclined to be aggressive, dominant, non-nervous and/or they had an inferiority complex (Tab. 3). This personality does not agree with the sensitive and dependent character commonly found among the Japanese. A comparison of usefulness of YG and MMPI for the purpose of predicting the possibility of wearing an epithesis through multiple regression analysis showed that YG was highly dominant (Tab. 3 and 5). We also citrried out an interview based upon our protocol including 32 items to evaluate the pattern of behaviours of facial defect patients in some occasions. Multiple regression anaaysis made it clear that eight items were very useful to foresee the possibility of wearing an epithesis (Tab. 6). The item asking a patient whether he expected a change himself after prostetic rehabilitation had especially significant weight in the prediction. The contrast noted in the arswers to the item between the epithesis wearing group and the non-wearing group 8uggested that the attitude towards the epithetic appliance had already been decided before the treatment started and that a patient who had a negative prediction in his self-image after prosthetic rehabilitation never wore an epithetic appliuce h the end. It was also down that high probability of wearing epithesis was expected in the male and/ or in the patient with no occupation.

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The unidentified clinical syndrome has been characterized with vague or shifted autonomic disturbances without any organic findings. The present study was conducted in order to chasaify this syndrome according to clinical features, with respect to which complaint was more closely related to others. The subjects consisted of 60 males and 149 females, with ages ranging from 20 to 79. All demonstrated lasting complaints for two months or more and did not show any overt neurotic behavior. Twelve groups were provided of assorted ages and sex, and the frequency of 30 complaints in each group was then computed. Principal component analysis was applied to the twelve original groups as variables for the 30 complaints. Three components were extracted; the first component, which accounted for 57% of the total variance, presented a common denominator, second and third components were clearly dominated by age and sex factors respectively. According to the component scores computed from components 2 and 3. all complaints were clustered on a two-dimensional space. Results were as follows; older males revealed more depressive complaints such as insomnia, diarrhea, constipation etc., whereas younger males suffered from general fatigue and asthenopia which was suspected to be a underlying asthenic reaction. On the other hand, in females, an age-dependent change was not observed. They were more closely related to an anxiety reaction involving dygnea and dizziness. It can be considered that the unidentified clinical sydrome may be classified into three syndrome clusters and that there are different underlying mechanisms for each one.

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The field of liaison psychiatry in Japan has been drawing gradual attention in recent years. There is some confusion as to the definition and function of liaison psychiatry. The authors think that the participation of psychiatrists in the care of All patients is the essence of liaison psychiatry. We attempted the participation of psychiatrists in the treatment of all patients in the primary care department of Kawasaki Medical School. Of 412 inpatients, 63.3% were subjects of liaison psychiatry, and 24.3% shoewed a neurotic reaction after admission. The hcidence of neurotic reaction was related to the length of hospitalization, process of the illness and the acceptance of the physician in charge. It may be concluded from these results that liaison psychiatry has greatly expanded the area of psychiatry and that its involvement in therapy is needed. Education of general physicians, changes in psychiatrists themselves and considention of the cost of liaison psychiatry work are needed for the development of liaison psychiatry.

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We studied "psychogenic" hearing loss childhood from a point of psychosomatic Medicine, The subjects were 12 cases who had been diagnosed as "psychogenic" hearing loss at the outpatient clinic of otology in Children-s Medical Center of Osaka, and they were consulted with department of psychiatry. We analyzed the subject to learn the relationship between clinical observations and a psychological test, Rorschach test, WISC or WISC-R, GAT, etc. The age of the subjects ranged from 8 and 11 years old, the mean years old. (male 1,female 11) They showed hearing loss between 18.75 and 92.5 dB at audiography. But at ABR, they all showed normal response. 9 cases were pointed out hearing loss by general medical check at school despite no complaint, 3 complained of hearing loss by themselves. 7 cases of all had psychosomatic symptoms such as headache, autointoxication asthmatic attack. In paticular, 5 cases had functional visual dysfunction. 8 cases were examined by WISC or WISC-R. 7 of them had average IQ, while one had borderline IQ. 4 cases who were not examined by IQ test were observed to have average intelligence. In family relation test, a parent or parents of 5 cases felt negative tendency. In Rorschach test, they were charecterized with location determinant, form level, content. 7 cases were examined to EEG it was learned that one had borderline EEG. Then, we classified the subjests into three types according psychologial test, mainly to Rorschach test. Type 1 was named as over-adaptation group. As to the results at Rorschach test, they showed W%>D%, higher W% than average for their age. They got tense easily, and were sensitive, passive and supressive of their emotions. Type 2 was named as pre-adaptation group. They showed D%>W%, higher F(-)% than average. Their character was social immaturity. Type 3 was named as mal-adaptation group. They responded little to Rorschach test, especially form level. Their character was egocentric and subjective. On the basis of this classification, it is possible to speculate the course of clinical symptom and prognosis. Type 1 had little or no complaint; their symptoms were transient and their prognosis was good. They could be considered psychosomatic type. Type 2,their course and symptom were changeable. Many of them showed abnormal EEG. It was thought that this group might involve children with MBD tendency. Type 3 complained of many symptoms, had functional visual dysfunction. Their course was cyclic and prognosis was not good. This type might involve hysterical mechanisms. This classification was effective for the therapeutic approach and it should be pointed out that "psychogenic" hearing loss in childhood involve not only hysterical mechanisms but also psychosomatic mechanisms.

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