The present study aims to assess the effects on mood of a free dynamic dance accompanying high speed music (Kachaashii, an Okinawan folk dance which is usually performed in an exciting atmosphere) . Forty-eight females (ages : 25-63,average : 44.0) were divided at random into 2 groups, Dance and Control groups. Dance group performed Kachaashii, while the other was given a rest period. Both groups took pre- and post-tests of POMS. GLM analysis made it clear that Kachaashii had significant effects on each of the 6 states of POMS. In other words, Dance group and Control group responded differently to the tests. Dance group scored higher on Vigor, while scoring lower on the rest of POMS, namely Tension, Depression, Anger, Fatigue, and Confusion. Therefore, it is tenable to say that Kachaashii is effective enough to increase Vigor, to relax Tension, to alleviate Depression, to soothe Anger, to decrease Fatigue, and to ameliorate Confusion. In addition, the Dance group performed differently on POMS before and after the dance : Vigor scores increased significantly, while Tension, Depression, Anger, Fatigue, and Confusion scores declined significantly. The Control group did not record much changes.
Healthy adult men were divided into three groups according to their natural killer (NK) cell activity, namely high, intermediate and low activity groups. The psycho-behavioral responses, life event stress, work situation, degree of fatigue and viral antibody titers in these groups were compared. Subjects with low NK cell activity were found to show passive and introverted psychobehavioral responses, to have experienced many life event stresses and have few goals to live for. Many of these subjects were busy and always anxious about their work. Furthermore, they had strong feeling of fatigue and exhibited high degrees of mental and physical fatigue. Subjects with high NK cell activity were found to have positive, extroverted and slightly nervous temperaments. Many of these subjects exhibited type A behavior patterns. Despite long work hours, few felt heavy responsibility and troubled interpersonal relationships in their workplace. Many were satisfied with their present job. There were no differences in the degree of mental or physical fatigue between the intermediate and high groups, but the subjects in the high groups had strong feeling of fatigue. There were no significant differences in viral antibody titers among these three groups. These results suggest that NK cell activity is related to psycho-behavioral responses, stress coping, goals to live for, and the degree of fatigue.
We assessed the usefulness of the Tokyo University Type Egogram (TEG) as a measure of ego state involvement in the onset of obesity and a predictor of the effects of weight reduction program. The TEG profiles of young obese patients were slightly characteristic, while the TEG profiles of all obese subjects and of middle-aged obese patients were the same as the profiles for healthy individuals. Thus, no psychological characteristics specific to obese individuals were revealed by the TEG. When the association of TEG patterns and increase levels in the body mass index (BMI) were examined, males showed no particular relationship between the TEG scales and the BMI. However, young females with a BMI over 28 had higher gradients of from A to FC and AC, strongly suggesting a tendency for self-negation. Middle-aged subjects with a BMI over 32 had an opposite relationship between FC and AC. Our servey of the history of disease and eating habits in individual subjects revealed that eating disorders tended to develop after strict diet control in young people. It seems likely that binge-eating, which is viewed as a problem from the viewpoint of psychosomatic medicine, is related to the magnitude of the patient's desire for weight loss and not related to the BMI. When the correlation between TEG scales and the percentage of weight loss was positively correlated with NP, A and FC in males and negatively correlated with AC in males, suggesting the usefulness of the TEG in predicting the effects of weight reduction programs in males. In females, however, the positive correlation between FC and the percentage of weight loss in young females was the only correlation observed.
Type A behavior pattern has been established as a risk factor for coronary heart disease. It has been suggested that Type A individuals who are characterized as hard-driving, competitive, time-urgent, and impatient tended to increase stressors such as daily hassles and stressful life events. The present study examined the effects of Type A components on stress responses and daily hassles in university students. To accomplish this, a questionnaire that consists of Type A behavior pattern scale, daily hassles scale, and psychological and physical stress response scale was administered to 708 students in Okinawa. The results were as follows. For Type A components, 3 factors were extracted by a principal component analysis : aggression factor, hard-driving factor, and time urgency factor. Multiple regression analysis revealed that daily hassles and time urgency were positively related to psychological stress responses in male. Daily hassles and aggression were positively related, however, hard-driving was negatively related to psychological stress responses in female. Daily hassles, time urgency, and aggression were positively related to physical stress responses both in male and female. Each multiple regression model showed that daily hassles contributed most significantly to their prediction. Aggression and time urgency were positively related to daily hassles both in male and female. These results show that daily hassles are most effectively to predict stress responses, and aggression and time urgency are effectively to predict daily hassles. It is supposed that hard-driving will suppress psychological stress responses only in female.
Primary alveolar hypoventilation syndrome, although rare, usually results in long term mechanical ventilatory support because of its chronic hypoxic and hypercapnic pathophysiology. A 58-year-old female was admitted for the evaluation of general exhaustion and marked weight loss with BMI 13.1. The patient presented serious desaturation with excessive daytime somnolence and morning headache despite normal pulmonary and neuromuscular function. After pneumonic involvement, the patient became controlled under transtracheal ventilation for two years. The patient gradually developed depressive with suicidal idealing due to discomforts and poor QOL caused by lasting tracheostomy. The phrenic nerve pacing was not attempted because preoperative assessability and CPAP trial did not bring any improvement for desaturation. Altemative to BiPAP application improved mean oxisaturation 91% up to 94% and revealed marked reduction of hypoxic episodes during sleep. After efficacy of BiPAP was confirmed by ambulatory oximetric monitoring, tracheostomy was closed two years later. The closure of tracheostomy brought improvement of QOL associated with recovery of self-esteem. The case encourages us that undesirable symptoms, such as depression, paradoxically may break clinical deadlock and provide therapeutic success.
This article demonstrates the clinical application and the efficacy of two relaxation methods such as progressive muscle relaxation and autogenic training in the general hospital psychiatry. During the months between April through July 1993,ten patients were treated with these relaxation methods. Out of the ten patients, two were treated at the emergency service, four at the outpatient clinic of psychiatry and four were referred from the medical/surgical ward. Their symptoms were hyperventilation attack, panic attack, neurotic insomnia, agoraphobia and chronic pain and so on. As a result, nine patients out of ten (90%) were effectively treated with these relaxation methods. One patient with no improvement was suffering from insomnia. These methods should be more applied in the clinical settings of general hospital psychiatry for the following reasons. First, these relaxation techniques are simple and useful methods which are easily employed in general hospital psychiatry. Second, physically ill patients are likely to suffer from adverse reactions of psychotropic medications. Third, these methods can produce a rapid improvement especially for anxious patients with panic attack and/or hyperventilation syndrome. In this article, the modified methods of autogenic training and progressive muscle relaxation, which are more easily applicable in general hospital settings, are also demonstrated.
A 45-year-old woman had suffered from anorexia nervosa (AN) and bulimia nervosa (BN) since she was 18-years old, but had few medical or psychological treatment until she developed osteomalacia and gait disturbance seven years after onset. Diagnosis of AN and BN had been confirmed and patient had been admitted to the hospital and behavior therapy with general psychotherapy was started. A subsequent 3-year hospitalization led to minimal symptomatic recovery. Twelve years after discharge she was readmitted to the hospital due to shortness of breath complicated by a mixed metabolic acid-base disturbance, chronic renal failure and left renal atrophy. The clinical data suggested that the patient's kidney failed to compensate for the rise in blood pH because of hypokalemic nephropathy. A central respiratory disturbance developed (PCO_2 > 55 mmHg) to compensate for the existing metabolic alkalosis.
We reported the case of a 58 year old man who began to have attacks of bronchial asthma 2 years jpreviously. In spite of repeated hospitalization following the first attack, it was not possible to control his attacks effectively because conventional therapy for bronchial asthma was not effective and because he erratically demanded treatment that he desired. Therefore, he was admitted to our department of psychosomatic medicine. We started our psychological treatment after asthma attacks remitted following treatment with theophylline, β_2-stimulant inhalation, minor tranquilizers and the regular administration of beclomethasone dipropionate inhalation. The patient revealed that his wife has died in a traffic accident 6 months before the onset of asthma attacks, and that he was feeling lonely. So we provided opportunities for him to ventilate his feelings. The psychological interview with him also revealed that besides asthma attacks, he often experienced hyperventilation attacks and anxiety attacks and that he was unable to distinguish these attacks one from another. So we educated him to discriminate between these different types of attacks. As a result of these interventions there was a remission of his symptoms. Several psychosocial factors are responsible in most cases of late onset bronchial asthma, therefore, psychosomatic treatment is appropriate for such patients.
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