[in Japanese]

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Egogram is a sort of psychological scales theoretically based on Transactional Analysis. Tokyo University Egogram (TEG) published in 1984 was a questionnaire with high reliability and validity. Since then, it has been widely used in various fields such as medical care, education, and industry. The second edition of TEG was published in 1993 after three years of basic studies. In this study, we investigated the usefulness of TEG 2.0 for its clinical application by means of examining correlations with other psychological tests; Cornell Medical Index (CMI), Profile of Mood States (POMS) and Self-rating Depression Scale (SDS). The statistical methods used were as follows : 1. Calculating and testing correlation cofficients among 5 scales TEG-CP (Critical Porent), NP (Nurturing Parent), A (Adult), FC (Free Child) and AC (Adapted Child) and the scores of the other psychological tests. 2. Profiles outlined by 5 scores of TEG are interpreted as total ego states. Thus, we applied multivariate analyses to deal with 5 scales simultaneously. Canonical discriminant analysis with CMI as the Class was conducted on CP, NP, A, FC and AC as the independent variables. Multiple regression analysis with POMS and SDS as the dependent variables was performed on CP, NP, A, FC and AC as the independent variables. The results of these analyses were summarized as follows : 1. Correlation coefficients : (a) There was a significantly positive correlation between CMI and AC. (b) Regarding subscales of POMS, there found some significantly positive correlations with CP, FC and AC; CP and Anger-Hostility, FC and Vigor, AC and Tension-Anxiety, AC and Depression, and AC and Confusion. (c) There was a significantly positive correlation between SDS and AC. 2. Multivariate Analyses : (a) The canonical discriminant analysis with CMI as the class showed that AC had a significantly positive canonical coefficient. It was suggested that one with higher score on AC was more neurotic. (b) The multiple regression analysis with POMS as the dependent variable showed that AC and CP had a significantly positive partial regression coefficient. It was suggested that one with higher scores on AC and CP showed more negative feelings. (c) The multiple regression analysis with SDS as the dependent variable showed that AC and CP had a significantly positive partial regression coefficient and that A had a relatively small but significantly negative partial regression coefficient. It was suggested that one with higher scores on AC and CP and lower score on A showed more depressive feelings. Consequently the usefulness in clinical application of the second edition of TEG was confirmed by these results of this study.

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Purpose : This paper aims to know whether or not neurogenic pain and psychogenic pain can be separated in the clinical entity of chronic pain. Subjects and methods : Forty patients, 16 men and 24 women with the mean age of 44-ys, sufferring from long-lasting pain were divided into 3 groups from the standpoint of existence of neurosurgical organic lesions. Group A consisted of patients with organic painful lesions, group B meant patients with organic lesions but pain provoked mainly from myofascial irritation, and group C contained patients who had no organic lesions. Group A is a neurogenic pain group; groups B and C are equal to "somatoform pain disorder" in DSM-III-R. Each group had been given the same psychological tests by a psychologist. Results : All groups showed a somewhat neurotic tendency. Group A revealed a reactive neurotic tendency, group B was fully influenced by social problems associated with the patients, and group C showed a neurotic character which had mostly acted as a factor to continue activating their pain. Conclusion : In chronic pain of any kind, both neurogenic and psychogenic mechanisms react compensatively with each other.

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We provided biofeedback (BF) therapy for the purpose of relaxation of two patients who showed anxiety, tension and hypochondriacal symptoms and were diagnosed as a generalized anxiety disorder according to DSM-III-R. During the therapy from 3 to 10 months, two patients were received to be studied for clinical symptoms, MAS and CAS scale and immunological indicators including natural killer (NK) cell activity and proportion of lymphocyte subsets. One of the patients (Case 1) responded effectively to the therapy and showed improvement of the symptoms, a decrease of MAS and CAS scores and an increase in NK cell activity. In contrast, the above indicators were not changed in the other patient (Case 2) who did not show to be effective to the therapy. Both cases showed no change in the proportion of T cell subsets such as CD 4 or CD 8 bearing cells in preand post-treatment of BF. The results obtained from these two cases indicate the good correlation between improvement of symptoms in anxiety neurosis and NK cell activity. It is thus suggestive from our results that NK cell activity may be a good indicator to determine the effectiveness of BF therapy in a long-term therapeutic course.

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Two hundred and ninety nursing students were examined using a questionnaire regarding their interest in and understanding of patients' mental state, interest in terminal care and hope of practicing it, their ways of thinking in relation to artificial prolongation of life and giving cancer information to other persons, family members or receiving it themselves, experience of being an outpatient or having been admitted into a hospital, and experience of a death in their family. The results were as follows. (1) Although the majority of students were interested in the mental states and terminal care of patients, only a minority of them understood the meaning of mental states and hoped to practice terminal care. (2) Regarding attitudes toward artificial prolongation of life, "passive prolongation" was most accepted when compared to "passive euthanasia" or "active prolongation" which was rarely supported. On the contrary, an increased proportion of "active prolongation" and "passive euthanasia" were observed when they were asked regarding their own family members. Most of the students opted for "passive euthanasia" for themselves. (3) Concerning whether or not to inform a patient of cancer, most of the students generally agreed to tell patients the real diagnosis. However, it was seen that many students would tell a member of their family the truth if possible, but there was an increase in the number of those who would tell the member of the family directly and those who would refrain from telling the truth if possible. Most of them wanted to be told about their own cancer. (4) Those students who had experienced being in a hospital as an outpatient tended to want "passive euthanasia" for themselves. Those who had experienced time in a hospital were inclined to be more interested in terminal care and to directly inform a patient of his/her real diagnosis. Furthermore, those who had never experienced a death in their family tended to desire to be told when they had cancer.

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In an ealier study we investigated the psychological aspects of fasting therapy with Naikan, using questionnaires, the Rorschach test, and the Baum test. Our results showed that all patients showed some improvement, and that the therapy contributed toward psychological stability. In the present study, we increased the number of subjects, and used standard psychotherapy as the control condition with which to assess the effectiveness of fasting therapy, its suitability for effect, and its adaptability, based on results from CMI, YG, TEG, and the Rorschach test. The subjects were 37 patients hospitalized due to psychosomatic disease and neurosis who had undergone fasting therapy. Fourteen of these cases were followed for half a year. Controls were patients, matched for age, sex and disease, who had been suffering from psychosomatic disease or neurosis and had been given psychotherapy. The effect of fasting therapy was assessed by having the case physician evaluate patients under nine headings (symptoms, mental stability, interpersonal relations, understanding of the disease, attitudes toward work, disposition, cheerfulness, emotional control, and judgment) all measured on a 4-points scale. No patients received a negative assessment, and treatment was judged to be highly effective in 18 cases and somewhat effective in 19 cases. The 5 patients who interrupted therapy were similarly studied. The results showed that the standard psychotherapy group showed some improvement in subjective self esteem, but little change in deep personality structure. In comparison, those who continued with fasting therapy steadily improved in subjective self esteem, emotional control, ego strength, and self image. In those patients showing a marked improvement, there was also some improvement in conflict concerning affective wants. These results suggest that the fasting therapy induces in patients a sense of having been "psychologically reborn" after having undergone an extreme physical state. As we had expected, the effects of fasting therapy gave rise to the following observations : questionnaires are inadequate for revealing changes in deep personality structure, while patients in whom the effect of therapy was less pronounced seemed to have less imagination and empathy, but greater internal tension. Furthermore, although the patients who were unable to complete therapy were good at affective expression and introspection, they also tended to be aggressive and to have anxiety about affection. For that reason, these patients are less well suited to undergo fasting therapy with its many restrictions, accordingly, a more mild form of therapy should be devised for these patients.

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Bronchial asthma is a disease that may become chronic even if adequate physical treatment is carried out. Because of this, it may on some occasions impair the quality of life (QOL) of the patients and therefore it is important to evaluate the QOL of asthma patients. This study examined the relationship between the QOL and somatic as well as psychological factors of 50 asthmatic patients attending an outpatient clinic. The somatic factors studied were; sex, age, onset, duration, severity and frequency of asthmatic attack, serum IgE level, peripheral eosinophil count and pulmonary function. The psychological tests administered were ECL, CAI, MMPI-AS and STAI. To evaluate the patient's QOL, "The Living with Asthma Questionnaire" was used. The results indicated that the QOL of female asthmatic patients was significantly lower than that of male patients. No significant relationship was found between other somatic factors and the QOL of the patients of either sexes. It was also found that the QOL of the patients with higher scores of the CAI and in the AC of ECL were significantly more impaired. These results suggest that the QOL of asthmatic patients are affected by both somatic and psychological variables. The present study indicates the importance of a holistic approach to bronchial asthma patients.

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We have investigated the possible effect of stress management on control of diabetics while they were in hospital for the purpose of education of diabetes. Group A; stress management (+) Group B; stress management (-) &lrtri;FPG (Fasting Plasma Glucose discharge-Fasting Plasma Glucose on admission) are Group A; 31.5±18.7 mg/dl and Group B; 47.9±22.5 mg/dl (p<0.01). &lrtri;FPG/FPG on admission×100 were 18.5±10.1 in Group A and 26.7±7.6 in Group B (p<0.05). We think that stress management is useful for control of diabetes.

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