The correlations between emotional stress, mental condition, life stress or behavior pattern and the attack of acute myocardial infarction were investigated on the moment of attack or for 1 week prior to the attack in 96 patients admitted into a coronary care unit.1) Acute emotional stress provocated the attack only in 4 cases. In 64 cases, no events to increase cardiac works were found at the time of the attack.2) As to life stress orphysical condition 1 week prior to the attack, 42 among 89 cases were exhausted due to continuous life stress such as busy job, family trouble, etc.3) Most of these cases with exhaustion were under 59 yrs and their attacks of myocardial infarctin were followed by previous unstable angina, and not by stable effort angina.4) It was concluded that, in consideration of phychosomatic factors as a pathogenesis of acute myocardial infarction, continuous life stress is more important than acute emotional stress, and that the role of these stresses was different according to the type of attack of myocardial infarction.

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The purpose of the study is to develop and to study validities and reliabilities of translated version of the Eating Attitudes Test (EAT) developed by Garner et al.1. The subjects of the study were 35 female anorexics before psychosomatic treatment (AN group) (average age 20.5±5.3,average duration 4 years). The control subjects were as follows : 26 female anorexics on psychosomatic treatment (ANDT group) (average age 21.1±6.5,average duration 3.5 years), 414 healthy female control subjects (FN group) (average age 18.8±2.4).2,20 out of 40 items were extracted by a good and poor analysis (t-test). Using the 20 items, three meaningful factors, namely food obsession (F1), dieting (F2) and phodia of obesity (F3) were factors analytically extracted.3. To study the validity of the factors and their combined EAT (EAT-20), correlational study was conducted between the scores of F1,F2,F3 and EAT-20 and clinical scales of the Kyushu University Medical Index (KMI). Followings were significant : F1 and KMI Obsessive-compulsive neurosis scale; F2 and KMI Obsessive-compulsive neurosis scale ; F1 and KMI Hypochondria scale; F1 and KMI Depression scale. A correlation between F3 and past percent maximum body weight was significant.

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The aim of present study is to elucidate the incidence of anorexia nervosa and to discover how common it is that young malnourished students have problems in their body image and eating styles. An epidemiologic study was performed using a total of 24,837 boys and 24,853 girls in junior and senior high schools. Initially, malnourished students below 20% of Broca's standard body weight and students with fluctuating body weight were chosen with the cooperation of teacherts, in a student health survey. Secondly, each student chosen was surveyed using a questionnaire, and those who corresponded to each of following three criteria were selected; 1) Below 20% of standard body weight and weight loss of not less than 2kg, nor more than 5kg from original body weight, with either a desire to be slim or weight phodia. 2) Weight loss of more than 5kg from original body weight. 3) Amenorrhea. Then, each student secondly selected was interviewed, and finally one junior high school boy and 6 senior high school girls were diagnosed as anorexia nervosa according to Suematsu's criteria. Thus the average incidence of anorexia nervosa was ascertained as 0.011% and 0.064% in junior high school boys and senior high school girls respectively. There was significant difference in incidence between the northern part of this prefectuce (0.024%) and the southern part (0.284%). Fukui City, which is the biggest city in this prefecture with a population of 247,254,has the incidence of only 0.028%, but Obama City, which is the rather smaller city with a population of 33,753,has a higher incidence of 0.427%. Fukui City is located in the northern part, and Obama City is in the southern part.Fukui prefecture is politically and linguistically divided into two parts, the northern part and the southern part. In the southern part, Keihan-accented language is used popularly, but not in the northern part. This fact means that the southern part may culturally belong to the Keihan areas as well as the big cities such as Osaka City or Kyoto City at least linguistically.Although 23.7% of malnourished girls have some problems both in body image and eating styles, there was no significant difference between the northern part and the southern part.These data suggest that some cultural factors of city life may take an important role in increasing the incidence of anorexia nervosa, but may not influence body image and eating style in different parts.

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A psychosomatic case study of 10 patients with recurrent AMI was performed.One was a female and nine others were males. Their ages at the first attack ranged from 38 to 69 years. All patients were in a stressfull situation prior to AMI onset. Nine of them showed the type A and one non-type A behavior pattern identified by interview, JAS and author's questionnaire method. With managing class patients, their emotional stress was concerned with occupational involvement and hard-driving tendencies. Most of them did not make any effort to alter their type A behavior pattern after their first cardiac crisis. Thus it can be expected that is patient did not alter his type A behavior pattern after initial AMI attack, he had a severe risl of recurrent AMI. Psychosomatic risk factors associated with the first AMI attack may become the risk factors for recurrent attacks.Patients with the type A bahavior pattern seemed to have the following tendencies in their daily lives.1. Tendency to make vicious circle between excessive involvement in job and emotional stress by job.2. Tendency to involve and accelerate other coronary risk factors.3. Tendency to have wrong over-confidence, lack of self-awareness of being ill, and of proper self-control to prevent secondary heart attack.The type A behavior pattern should be considered as one of the most important risk factors for recurrence of AMI.Further clinical approach for the secondary prevention of AMI may be promoted by psychosomatic studies of the possible role played by the type A behavior pattern.

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Dance therapy has been conventionally employed for patients with psychoses and mentally retarded children. We have applied this therapy to patients with psychosomatic diseases and neuroses for 5 years since 1980,and found it to be effective in the management of various psychosomatic symptoms that were not alleviated by conventional physically-oriented treatment.Special attention was paid to the following points in performing the dance therapy.1) The patients were sufficiently motivated by the physician or the family to participate in the therapy and are actively supported by them. 2) A large unmber of healthy volunteers participated in the dance sessions. 3) Efforts were made to create understanding and sympathetic atmosphere that would encourage conversation between the therapists and the patients, or among the patients. 4) Dancing was performed according to a predetermined style, but extensive movements freely ignoring trivial technical considerations were encouraged. 5) Autogene training was practiced during rest between dance sessions to learn techniques of relaxation.Aerobic exercise, discotheque-type dance and group dancing were employed for the therapy.This therapy had favorble effects within a short time on neck and shoulder stiffness, muscle contractino headache, depression, nervous gastric symptoms, insomnia, autonomic imbalance, refusal to work, erythrophodia, and facial tic, etc. These symptoms were markedly improved in 82 (83.6%) of 98 patients and alleviated in 11 (11.2%). Of 450 healthy individuals who voluntarily participated in the therapy, those examined replied that they became more cheeful, more capable of forming closer human relationships, or more physically active, and noted improvements in their character, social relationships, and attitudes toward daily activities.Physical and psychological effects of dance therapy in the treatment of psychosomatic disorders may be summarized as follows : 1) Maintenance and improvement of physical fitness. 2) Enhancement of brain functions through stimulation of peripheral regions. 3) Release of repressed emotions. 4) Benefits from participation in the group. 5) Psychological stability brought about by escape from familiar environment and routine activities. 6) Effects as art therapy. 7) Benefits from altered state of consciousness, if experienced.

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