Recently, there has been an increase in the number of chronic eating disorders of more than 10 years duration from the onset. The reason is that are many severe psychopathologies in chronic eating disorder, and dependence on several poor prognostic factors. These include desire to be thin, a denial of maturity and feminity, and pathological symbiosis, which are remarkable in the chronic patients. In this paper, we report the findings obtained from a 48-year-old woman suffering from gait disturbance with severe body pain, who was given psychoanalytical psychotherapy in the ward based on psychoanalytical understanding. She entered a contact, and was able to stay for a maximum of 6 months in our hospital. In the therapy, she was given the most feasible target, which thus supported her. Still more, working through was added to bring into focus the negative convinction and self-destractive tendency. As a result, she was able to leave the hospital after 7 months and live alone at an apartment near the hospital.

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Using a control group of 30 persons and 192 pregnant women, we investigated th body sway test (BST) and microvibration (MSV) as an indicator of the state of the autonomic nervous system. In the control group, these examinations were done after rest, after mirror drawing test (MDT) and after autogenic training (AT), respectively. We studied the changes in data of these examinations, as well as these data in relation to the differences which were found between the normal and abnormal groups of the Yatabe-Guilford test (YG) and Cornell Medical Index (CMI). 348 samples of BST and MV were analyzed with the 192 pregnant women. The data of the pregnant women were compared to those of the control group. The measurements for BST included the locus length of body's center of gravity (LL), standard division of amplitude in the lateral (XSD) and the anteroposterior direction (YSD), and average spectral frequencies of 0.0-1.0Hx (XM1,YM1) and 0.12-1.0Hz (XM2,YM2) of each direction. The MVs were divided into 5 components; MV(0.5-4Hz), MVα(8-13Hz), MVβ_1(13-20Hz), and MVβ_2(20-30Hz). The results were as follows : 1. Control group. 1) XM1 with eyes closed decreased (p<0.05)after the MDT. YSD with eyes open increased (p<0.05) and LL, XM1,YM1,XM2,YM2 with eyes closed decreased (p<0.01,p<0.05,p<0.05,p<0.01andp<0.01,respectively) after AT. 2) MVβ_1 increased (p<0.05) after AT. 3) For each parameter of BST, no significant differece was found between the normal and abnormal groups of YG and CMI. But MVθof YG abnormal group was lower than that of the YG normal group (p<0.05), and MVβ_1 of the CMI abnormal group was higher than that of the CMI normal group (p<0.05) after AT. 4) Significant correlation doeffecients were found between MVθand YSD (p<0.05) , MVθand YM1(p<0.01), MVβ_1 and XSD (p<0.05), MVβ_1 and YSD (p<0.05), and MVβ_1 and YM1(p<0.01). 2. Pregnant woman. 1) Pregnant woman had smaller LL, XM1,XM2 and YM2 than the control group (p<0.01,p<0.05,p<0.01 and p<0.05,respectively). 2) Pregnant women had higher MV, θ, β_1,β_2(p<0.01,p<0.05,p<0.01 and p<0.01,respectively) and lower MV α (p<0.05) than the control group. 3) LL, XSD and YSD at the 4th month of pregnancy were lower (p<0.05,p<0.05 and p<0.01,respectively) and LL, XSD and YSD at the 10th month of pregnancy were higher(p<0.05,p<0.05 and p<0.05,respectively) than the average values for all pregnant women. 4) XSD of premigravida was smaller than that of multigravida (p<0.05). MVθ of grimigravida was lower than that of multigravida (p<0.01) 5) Significant correlation coefficients were found between MVθand XSD (p<0.05), MVθ and YM1(p<0.05), and MVβ_1 and XM2(p<0.05). We suggenst that these 2 examinatins are useful to measure the state of the autonomic nervous system.

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Psychological and social backgrounds are considered among the most important factors involved in the onset, severity and intractability in any type of bronchial asthma. On the basisi of the results of an diary of asthmatic attack and emotion, we reformed it by adding emotional items to it, adn analyzed their daily changes of attacks and emotions. We have previously demonstrated that workload (feeling) and fatigue (feeling) were among the important componetns to induce asthmatic attacks.We classified our patients into three groups : 1) the positive relation group in which a relation ws found between asthmatic symptoms and physical pressure or workload and fatigue, 2) the positive relation group in which a relation was found between mental pressure of workload and fatigue, and 3) the negative relation group. We have also reported the relationship between their conditions of asthma and psychological tests. In this report, we have examined the relationship between lung functions and their mental or physical conditions. 28 male adn 22 female asthmatic patients with the mean age of 53 years ranging from 1979,were selected and all these patients were known to have asthma as defined by the American Thoracic Society. Attack points, physical and mental points were collected from the diary evry week and plotted, and their correlations were statistically investigated. We divided them into two lung function groups as low (%FEV_<0.1>less than 60%) and normal (%FEV_<0.1> from 60%). There were many patients with steroid dependency, and physical and mental problems in the low lung function group. When patients who were related to psychosomatic factors and asthmatic attacks, became worse in their lung function, neurotic and depressive problems were more often observed in the majority of the indeviduals. From these results, we conclude that these patients may be difficalt to control in their asthmatic attacks with usual medications, and threfore a psychosomatic approach shoul be applied in order to avoid prolongation and intractability of the disease.

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We made a study on the psychosomatic factors of chronic hypertrophy of the palatine tonsils in adults. Our subjects were members of the Japan Overseas Cooperation Volunteers, whoworked in developing countries for 2 years. Group T consisted of those who dah chronic hypertrophy of the palatine tonsils (Grade II〜III by Mackenzie) and Group C consisted of controls without chronic hypertrophy of the tissues (Table 1). Those who had undergone tonsillectomy were excluded from this study. Blood examinations and psychological tests were applied in both groups under the same conditions during a 3-month training period before ssiognment overseas. Result; 1) With regard to the results of TPI(Todai Personality Inventory; a MMPI revised questionnaire), group T showed singificantly lower mean scores in the scales of Depression (p<0.05), Obsession (p<0.02) and Antisocial (p<0.02) than group C. These results indicated that group T had less depressive, less obsessive and more submissive personality traits as compared with group C (Table 2). 2) CMI(Cornell Medical Index) revealed no significant differences in neurotic tendency (by Fukamachi's criterion) between both groups, but group T showed significantly (p<0.05) lower mean scores in the scale of Fatigability. These results suggested that group T had less tendency to feel their own fatigue than group C(Table 3). 3) Conparison among habitual smokers showed that those in group T smoked significantly (p<0.05) more cigarettes per day than those in group C(Table 4). 4) Group T had a significantly (p<0.05) lower rate of those who had some hobby overseas as compoared to group C(Table 5). 5) By our original questionnaire, there were no differences of self-consciousness concerning psychologicanl maladjustment living in foreign countries between both groups (Table 6). 6) Group T had a significantly (p<0.02) higher incidence of medical care overseas than group C(Table 7). 7) The mean obesity index of group T was significantly (p<0.05) higher than that of group C, and ration of subjects with abesity index (%) over 10% in group T was significantly higher (p<0.01) than that of group C(Table 8 & 9). 8) Comoparing among males, the mean values of total protein, GPT and r-GTP of group T were significantly (p<0.01,p<0.05,p<0.05) higher than those of group C. On the other hand, there were no differences on the mean values of ESR (1hr), WBC counts and platelets counts between both groups (Table 10). 9) The mean values of corticosterone of group T(n=8) were higher (p<0.01) than those of group C(n=10)(Table 11). These results suggested that various psychosomatic factours such as personality, in particular, an "alexithymic tendency"behaviours and endocrine function are involved in chronic hypertrophy of the palatine tonsils.

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EMG biofeedback therapy of neuromuscular diseases, such as writers cramp and spasmodic torticollis, has been reported frequently. In this study, we report on the effective use of EMG biofeedback for essential tremor. Essential tremor is a disease of unknown etilology and effective reatment has not been established. However, we know that anxieties and tensions make it worse. We had a case whose diagnosis was neurosis with essential tremor. We noticed a remarkable correlation between cody and mind in this case. Then EMG biofeeedback was carried out in anticipation of breakaway from this correlation and we ensured a successfur result. We would like to place our hope on effectiveness of biofeedback therapy for other neurotic patients.

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The authors present a case of psychogenic auditory hyperesthesia (sound phobis). The patient, a 54-year-old house wife, wearing an anti-air raid hood to avoid aby kind of noise, showed severe diffiulty even in taking a bath and flushing the lavatiry. Therefore family members had to be cautious not to make any noise even when they use the refrigerator, alarm clock and television. Psysical examination did not show any organic brain disorders or otological disease. Accourding to the results of psychological testing, her intelligence was found in normal level, while personality wa characterized as lack of flesibility, dependency, and tendency to repress her dissatisfaction or aggression. Previous history should that she suffered from abnormal sesation at the temporal region when her wecond son was born. She had been deeply attached to her secomd son and worreid about separation from him. Because of her introvert trend, she could not express her own view about son's engagement. She began to have those symptoms after son's marriage, and severe sound phobia developed when she heard his first baby cry. During hospitalizetion period, she received Morita-oriented psychotherapy and assertive trraining. After 6 months of admission, she restored her normal life without being annoyed about ordinary sounds.

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A 37-year old female was admitted to our hospital because of intractable asthma on November, 1985. She suffered from lasting familial stress. According to our clinical observation, her symptoms were exacerbated with psychological srees and subsided with relaxation. It was considered, from the standpoint of psychosomatics, that her disease was caoused mainly by the confliction with her cominant parents and partialy by the one with her drunken husband. Furthermore, her husband had suffered from Buerger's disease after he became an adopted son of her parents. His disease became worse gradually although he had all sorts of therapy including some operations. On the other hand, her mother had suffered from intractable gastric ulcer after cohabitation with her adopted son. She had two sons. The elder son was healthy, however the second son had convulsive tic and allergic rhinitis. Her husband always preached a sermon only to his elder son with the result that elder son had his revenge on the second son. A series of stress like this was considered to be relatid with the cause of psychosomatic disease of the second son. After psychosomatic therapy, her symptoms improved because she understood her own psychological stress, the mind-body relationships. Therefore she became able to assert herslf to her parents and her husband. She decided to live apart from her parents. She also understood her familial psychological stress as mentioned above. Then she asked her husband to be kind to the elder son, the elder son to be kind to the second son and she advised the second son to argue against the elder son. Thereafter, owing to these approaches, her family changed for the better and became healthier. In conclusion, profound psychosomatic therapy elevate the quality of life not only in the patient but also in her family.

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We report here the case of a 15-year-old girl with anorexia nervosa (AN) and excsseve hypercholesterolemia. The patient started to lose her body weight in August 1986. Amenorrhea and an 11-kg weight loss were noted 8 months later. She was admitted under the diagnosis of AN in June 1987 when her height was 152cm and weight 28kg. Although she suffered fromseverce hypercholesterolemia (629mg/dl), her serum triglyceride level was normal (110mg/dl). An analysis of lipoprotein fraction revealed type IIa hyperlipidemia. However, there was no one in her family who showed hyperlipidemia. Her hypercholesteromemia returned to a normal level 7 weeks after admission. There have been few case reports which showed higher levels of serum cholesterol than the present case.

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