This study was based on the relation of techotress tendency with demographic characteristics and working conditions of computer operators. A questionnaire about technostress tendency and demographic characteristics and working conditions was asked to 280 (male=238,female=42) computer operators. The q, lestionnaire about technostress tendency consists of 26 questions. The criteria used for demographic characteristics were age, sex, marital status and status of education about computers. The criteria for working conditions included duration of work, working tine per day, duration of computer operation, frequency of breaks while operating computers, starting period for computer operation, amount of computer operation and amount of work on desk associated with computers. E ach question about technostress tendency was given a point according to the answer ; yes= 1,no=0,unknown=0.5 and the total points were used as the score to evaluate technnostress tendency. Correlation ceefficient was calculated to observe how the score was related to age, duration of work, working time per day, amount of computer operatioa and amount of work on desk associated with computers. Wilcoxon 2-semple test was ccnducted to examine how the score was influenced by sex, marital status, status of education about computers, frequency of breaks while operating computers, starting period for computer operation. For frequenty of break8 while operating computers, 2 categories were given-A 3 take breaks regularly or often, B : seldom take breaks or take no break. As the answer of starting period for computer operating, tbe following 2 categories were given-A : started operating computers upon entering companies. B : started operating computers after entering companies. The results show that techno-centered tendency is significantly higher in males than in fe males and higher in operators who seldom take breaks or take no break than in those who take breaks regularly or often (p<0.01). Techno-anxious tendency is significantly higher in operators who have never been trained in computers than in those who have (p<0.0l) and higher in operators who started operating computers after entering companies than those who started operating computers upon entering companies t)<0.05). It is suggested that males need to pay more attention to protect themselves from technocentered stress. It would be important to take breaks regularly or often while operating computers to protect computer operators from techno-entered stress. h addition, training in GOmputers for both beginners in the computers and people who start operating computers after entering companies would be effective to protect them from techno-anxious stress.

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This study discussed how technostress tendency was related to anxiety and ego state. Two hundred and eighty computer operators (male=238,female= 42) were investigated concerning technostress tendency, anxiety and ego state by a questionnaire. The questionnaire about technostress tendency consists of 26 questions with 3 answers to select from. STAI was used to evaluate anxiety and TEG was used to evaluate ego state. Each question about technostress tendency was given a point according to the answer (yes= 1,no=0,unknown=0.5) and the total points were used as a score to evaluate technostress tendency. Correlation coefficient was calculated to observe how the score was related to the points of anxiety (state-anxiety, trait-anxiety). Another analysis was conducted by using Wilcoxon 2-sample test to compare the scores between subjects who were in the egogram pattern and those who were not in it for each of 27 egogram patterns. Analysis of anxiety showed that a positive correlation was observed between the scores of techno-anxious tendency and the points of state anxiety (O. 89), trait anxiety (O.44), while no correlation was seen between the scores of techno-centered tendency and the points of anxiety. Analysis of ego state showed the following results. A) Techno-centered tendency is significantly lower in people who have the following 2 patterns than others (p<0.05) : l. a pattern in which NP is the highest, 2. a pattern in which NP, A and FC are high and CP and AC are low. B) Techno-anxious tendency is significantly higher in people who have the following 5 patterns than others (p<0.05) : 1. a pattern in which FC is the lowest, 2,a pattern in which CP, NP and AC are high and A and FC are low, 3. a pattern in which NP and AC are high and CP and A are low. It was indicated that techno-centered tendency had no relation with anxiety and that technoanxious tendency was related to anxiety. It was clarified that 2 egogram patterns were related to techno-centered tendency and 3 egogram patterns were related to techno-anxious tendency.

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Some patients complain of continuous or reccurent abdominal pain associated with high serum levels of pancreatic enzymes but without definite signs of chronic pancreatitis on various examinations including ERCP. CT and US. This condition has been called clinically suggested chronic pancreatitis (CSCP) . In this report, we propose a new pathophysiologic hypothesis and a strategy for the treatment of CSCP based on the viewpoint of system theory and phenomenology. A psychosomatic vicious cycle consisting of the following three processes is often observed in CSCP : 1) A depressive mood and anxiety induce hypersecretion of the pancreatic juice. 2) An elevation of the intraductal pressure resulting from the pancreatic hypersecretion causes abdominal pain and increases in the serum levels of pancreatic enzymes. 3) Exacerbation of the symptoms and the information of the abnormal examination results aggravate the depressive mood and anxiety of the patient. This vicious cycle is considered to exacerbate and prolong the disease in the presence of the constitutional factor of hyperreactivity of the pancreatic exocrine function. On the basis of this pathophysiologic hypothesis, we formulated the following therapeutic strategy from a viewpoint of system theory, focusing particularly on the physician-patient relationship. ( I ) Sufficient medical interview and physical examination ; ( 2 ) examinations needed to exclude malignancies ; ( 3 ) proper explanation of the disease ; ( 4 ) setting control of symptom as the goal of the treatment ; and ( 5 ) administration of anti-depressants, if necessary. In this report, the clinical courses of two cases of CSCP, a 39-year-old female and a 32-yearold male, treated according to this strategy are described phenomenologically, and the validity of the hypothesis and the therapeutic strategy is evaluated.

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The purpose of this study is to compare respiratory sinus arrhythmia (RSA) with baroreceptor reflex sensitivity (BRS) before and after phenylephrine injection and paced respiration. RSA was measured as the difference between maximal RR interval in the expiratory phase and minimal RR interval in the inspiratory phase. BRS was assessed by the computerized scanning of spontaneous variations in systolic blood pressures and RR intervals which reflect baroreceptor-cardiac reflex function (sequence scanning method ; Bertinieri et al., 1988) . Systolic blood pressure was measured on a beat-by-beat basis using the vascular unloading technique. In the Experiment l (Exp. 1), 16 male students were injected phenylephrine (lOO μg) into cubital vein at the midpoint (3 min) of 5-min rest or mental arithmetic. In the Experiment 2 (Exp. 2), 19 male students were left in a 3-min spontaneous breathing and then asked for three 100-sec paced respiration (24 cpm, 12 cpm, and 6 cpm). The results were as follows; Exp. I : The significant increases in RSA and BRS were observed after phenylephrine injection during rest. The correlation coefficients between RSA and BRS were significant both before and after the injection : r=.68 to .69 during rest and r=.64 to .80 during mental arithmetic. Exp.2 : While RSA increased in accordance with the slowing of paced respiration, there was not such a clear tendency in BRS. The correlation coeificients between RSA and BRS were also significant both in the spontaneous breath and three paced respirations : r=.65 to.72. Because parallel and correlated changes in RSA and BRS observed in Exp. I were considered to be a compensatory vagal response to the drug-induced elevations in blood pressure, it was reconfirmed that the sequence scanning method seems to be a valid estimation technique of vagal tone. In addition, the paced respiration maneuvers in Exp. 2 showed clearly that BRS is relatively independent of the respiration rate. These findings suggest that BRS is more suitable for assessing cardiac parasympathetic control than RSA because of its greater specificity.

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To investigate how to live a healthy psychosomatic life, I have constructed an IKIGAI scale and studied the problems of adolescence. In this study, I define IKIGAI as the state that people have a positive purpose, a sense of being full and social support. The features of the IKIGAI scale that have been characterized so far are summarized as follows : l) The IKIGAI scale has the reliability and validity enough to use. 2) The IKIGAI scale correlates to the things involving ego identity. 3) The students who show a high score of the IKIGAI scale have achieved healthier ego development than those with a low score. 4) The students who make a low score of the IKIGAI scale have a mother who tends to behave in the way of devaluing self-esteem of her child. The purpose of the present study is to make clear the further characteristics of the IKIGAl scale. Subjects are senior high school students (621 males, 789 females). The results of this study are summarized as follows : 1) The IKIGAI scale reflects the tendency of depression, particularly emptiness which is a characteristic of depression in adolescence. 9_) It is presumed that the IKIGAI scale can be a modulator of subjective stress, 3) It is hypothesized that those who keep a high score of the IKIGAI scale have less subjective stress and less stress reaction than those who make a low score. 4) It is thought that in order to know IKIGAI of patients, utilizing the IKIGAI scale is useful for the practice of holistic medicine.

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In the Department of Psychosomatic Medicine, Kyushu University, a chronic pain patient is defined on the basis of our clinical experiences and reviews of associated literatures as "the patient whose pain complaint or social or occupational impairment is in excess of what would be expected from the underlying organic pathology". We assessed the pathogenesis of each patient in this category based on a multidimensional evaluation including organic, functional and psychiatric diagnosis, as well as behavioral analysis and family analysis. In this paper, 40 cases who had been treated as having chronic pain on inpatient basis in our institute were studied regarding their clinical features. The results are as follows : 1) Before the first visit to us, they underwent various treatments at many institutes and several admissions. In addition, some cases underwent one or more operations for alleviation of the pain in vain. 2) An operation for a physical disease, a psychosocial stressor, an injury and a disease with no need of operation were considered to have functioned as the precipitating factor for the pain. Many patients developed their pain from an experience of a noxious stimulus as a trigger. 3) Psychiatric diagnosis made according to DSM-III-R showed that conversion disorder and major depression were the two most common disorders and that a few cases had hypochondriasis or social phobia. These psychiatric disorders led to the pain of the patients. As accompanying psychiatric diseases, there existed psychoactive substance abuse, panic disorder, factitious disorder or others on Axis I and some kinds of personality disorder on Axis II. 4) As functional diseases, there were deafferentation pain, reflex sympathetic dystrophy, tensiontype headache, irritable bowel syndrome, non-ulcer dyspepsia and aerophagia. 5) The comparison between the characteristics of depressive disorder and those of conversion disorder revealed that patients with depressive disorder were significantly more related to experience of a noxious stimulus. 6) Behavioral analysis suggested that operant learning mainly played a causative role in the pain behaviors of many cases. 7) In the operant pain patients, 4 types of consequence in their environment acted as reward contingent on their pain behaviors. These included solicitous response, avoidance of reality, avoidance of conflict and maintenance of family system. These results suggest that there exists a complicated pathogenesis consisting of various factors behind persistent and intractable pain. Therefore, it is necessary to evaluate chronic pain patients on the basis of detailed psychosomatic assessment. It is thus considered to be important to attempt to understand the psychological, social and existentional meanings of each paitient's pain.

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Kiko-therapy has been indicated for bronchial asthma, but its effect has never been evaluated objectively. Our case was a ten-year-old boy with severe asthma who had been undergoing long-term institutional therapy. He had a tendency to hyperventilate due to psychological factors and had been resistant to all kinds of therapy. During a four-month treatment with Kiko-therapy, both symptoms and peak expiratory flow rate (PEFR) were studied. PEFR increased significantly, strongly suggesting that Kiko-therapy contributed to the improvement of airway obstruction in this patient.

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Intense emotional stress or fatigue has been reported to create vulnerable environment for cardiac arrhythmia with or without underlying heart disease. We encountered a case of masked depression characterized by refractory ventricular arrhythmias and plural sensory disturbances. Although intensive cardiac examinations including left ventriculography detected no evidence of structural heart disease, administration of 4 kinds antiarrhythmic agents brought no improvements but side effects. Psychological evaluation revealed that the patient made a high score of SDS (Self-rating Depression Scale) and duplicated mourning episodes suggestive of depressive state. A Iow dose of Maprotiline produced marked suppresion of VPC (ventricular premature contraction) and relief of both paresthesia and parosmia. Our experience implicates that-in the absence of organic heart disease-a depressive emotional state may participate in the genesis of ventricular arrhythmias.

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We experienced three cases of anorexia nervosa who experienced marriage. So we will report the cases with some literatural review. Case 1,29 y.o. female : She has been brought up by stern father, stubborn mother, loose grandmother, and younger sister. She started dieting at the age of 18. She got married when she was 23 y.o., but was divorced after one year. Furthermore, her mother was admitted to hospital for her uterin sarcoma. From that time she manifested anorexia and amenorrhea, and after her mother's death binge and purge by laxative became manifested. She was married again at the age of 29,but she didn't show any improvement. Case 2,28 y.o. female : She had immature parents, nagging aunt, and sister. She started dieting at the age of 18 and when she got married at the age of 25,her binge and vomiting started. Since her husband was busy in his work and hobby, so she continued her abnormal eating alone. Her weight became under 80% of her standard weight, and amenorrhea occurred. She was divorced when she was 28 y.o. and admitted to hospital when 29 y.o. Case 3,31 y, o. female : She lost her sight of right eye by trauma at age 3. So her parents indulged in her. Her father died. Her mother is overprotective still now. When she was married at age 24,she suffered from renal dysfunction, which led her to special diet and diuretics. From that time on, her weight had decreased. When she was 27 y.o., binge and vomiting became manifested but her husband was unconcerned about wife's abnormality. She was divorced and admitted to hiospital at the age of 31. All of these 3 patients got worse and manifested anorexia nervosa in their marriage. Marriage is an important issue for anorectic patients. Their husband's character is critical but patients themselves selected such partners. The problem of marriage for anorexia and "anorexiaphilic" young women is an important and specific theme not only in therapy, but also in social psychosomatic medicine.

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