Japanese Journal of Psychosomatic Medicine
Online ISSN : 2189-5996
Print ISSN : 0385-0307
ISSN-L : 0385-0307
Volume 38, Issue 2
Displaying 1-43 of 43 articles from this issue
  • Article type: Cover
    1998 Volume 38 Issue 2 Pages Cover1-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • Article type: Cover
    1998 Volume 38 Issue 2 Pages Cover2-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • Article type: Index
    1998 Volume 38 Issue 2 Pages 83-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 84-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 85-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 86-87
    Published: February 01, 1998
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 88-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 89-94
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • Satoshi Ishikawa
    Article type: Article
    1998 Volume 38 Issue 2 Pages 95-102
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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    This paper reviews specially recommended diagnostic criteria of the patient with multiple chemical sensitivity (MCS) in Japan. Those members were issued from the government task-team of allergy and related disease in 1997.The following criteria can be used to establish the diagnosis of the patients with MCS. Based on the criteria, medical aspects of MCS patients who visited Kitasato University were introduced and reviewed.
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 102-
    Published: February 01, 1998
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  • [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 104-
    Published: February 01, 1998
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  • Tadashi Sasaki, Kazuhiro Yoshiuchi, Gaku Yamanaka, Shinobu Turugano, S ...
    Article type: Article
    1998 Volume 38 Issue 2 Pages 105-110
    Published: February 01, 1998
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    The purposes of this study were to report the current activity of consulation-liaison service mainly in germ-free wards of Department of Psychosomatic Medicine in University of Tokyo with the review of previous studies.The total number of consultation from 1994 to 1996 was 74 ; 19 in 1994,17 in 1995,and 38 in 1996. The rapid increase in number of consultees in 1996 was due to our beginning of consultation-liaison activity in germ-free wards. From June, 1996 to May, 1997,we were consulted on 30 patients in germ-free wards ; 13 patients for chemotherapy and 17 patients for bone marrow transplantation. From the viewpoint of psychooncology, psychological support of patients and staff in germ-free wards is so necessary that we should substantiate the system of consultation-liaison activity in this specific field.The important issues to be considered are as follows. Most of our consultees are from the department of internal medicine. The medical staff in other departments should also pay attention to the consultation-liaison activity. Another issue concerns the economical problem that we do not receive any rewards for our activity. Therefore, consultation-liaison services should be organized as a system both practically and economically.
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  • Yukihisa Shibayama, Koji Tsuboi, Koichi Nakano, Sueharu Tsutsui
    Article type: Article
    1998 Volume 38 Issue 2 Pages 111-117
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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    The purpose of this paper is to discuss the consultation-liaison service as the speciality of psychosomatic medicine.Between January 1992 and December 1996,we consulted 133 cases (male : 60,female : 73), a consulting ratio being 25.6% of the 496 total inpatients of psychosomatic medicine population. Internal medicine was most abundant (38.3%), secondly 26.3% from Surgery, 12.0% from Orthopedic Surgery, 7.5%, from Nephrology, 3.8% from Neurosurgery and 12.0% from others. The main diseases of the patients were more than 70 kinds with a wide range of variation. The contents of the requests included participation of psychological factors, depressive state, treatemnt as psychosomatic outpatients in the past, reasons for patients requesting psychosomatic therapy, and others.According to the axis I diagnosis of DSM-IV, mood disorders were found in 20.3%, adjustment disorders in 15.8%, psychological factors affecting medical condition in 14.3% and anxiety disorders in 9.0%. These 4 disorders occupied about 60% of total disorders.Contents of consulting course were assessment of mind-body correlation (29.3%), relied from uneasiness of diesease (24.1%), treatment of depression (13.5%), relief from uneasiness of examintion (9.0%), regulation of doctor-patient relationship (9.0%), and other psychosomatic approaches. 60.2% of consulting patients were discharged and followed up on the psychosomatic outpatient basis.These results suggested that consultation-liaison service was a speciality of psychosomatic medicine.
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 117-
    Published: February 01, 1998
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  • Hirotaka Kashiwase, Makoto Kato
    Article type: Article
    1998 Volume 38 Issue 2 Pages 119-126
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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    We examined the cases of consultation-liaison service at the department of psychiatry in our university hospital, and pointed out the present problems as follows : 1) The items listed in the consultation sheet of our department of psychiatry from other departments are not sufficient. We have no room suitable for psychiatric interview in each ward.In our hospital we have no specific department standing for psychosomatic medicine as seen in other university hospitals in Japan.2) There are still many general hospitals which have no department of psychiatry in Japan. Consultations from other general hospitals in the community are often referred to our department of psychiatry. General hospitals, especialy public ones, should open an outpatient clinic of psychiatry for at least half a day per week.3) As consultations are referred to the department of psychiatry by doctors of other fields without making an appointment, there are consultations in almost endless succession on the same day.4) The atmospheres of the ward of obstetrics and gynecology and that of pediatrics seem to be different from those of other wards. The major problems to be discussed are the pregnancy and delivery of the patients with mental disorders in the ward of obstetrics and gynecology, whereas the relationship between the pediatrician and the family of the child in the ward of pediatrics.5) The transfer of patients from other wards to the ward of psychiatry is sometimes difficult because of the opposition by psychiatric nurses. Therefore, we try to treat the patients in that ward through intensive psychiatric therapy in order not to transfer them to the ward of psychiatry.6) The patients with attempted suicide who are admitted to the ward of critical care medicine are all consulted with the department of psychiatry. Therefore, this system is more liaison than consultation service. Regarding those patients, we must assess mental disorders, re-attempted suicide, and discharge or transfer to the ward of psychiatry.7) We often see a patient with a comorbidity of mental and physical disorders, for example, schizophrenia and gastric cancer. We always have to fully understand both mental and physical conditions of that patient. It is often argued when psychotropic drugs, for example, should be restarted for the patient after the operation.8) Sometimes we are asked to treat staff and clerks of our own hospital. However, we are wondering if we should ask psychiatrists in other hospitals to see them.
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 126-
    Published: February 01, 1998
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  • Takanori Kikuchi, Aki Takano
    Article type: Article
    1998 Volume 38 Issue 2 Pages 127-134
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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    In this article, the authors, based on their investigations of the actual conditions in a general hospital, discuss the present state and the tasks of consulation-liaison activity from a relation-centered aspect. They believe that is the important core aspect of the activity.The investigations proved that patient-staff and/or intra-staff interpersonal relations problems ("relational problems") played a significant role in approximately 40% of the consultations studied. These problems occurred significantly less frequently in patients admitted following a self-injury and more frequently in patients admitted to medical wards, and those referred due to adjustment disorders related to their physical disorder or admission stress itself. This was also found to be true in patients with personality disorders, organic mental disorders in which strange speech and behavior patterns were apt to be misunder-stood as being caused by their personality, and psyco-socially initiated physical smptoms such as somatoform disorders and psychosomatic diseases.Clinically, relational problems appeared in the following situations : disturbances in the patient-staff relationship (44.2%), psychological distresses of members of the ward staff due to relational problems (37.2%), psychological and/or psychosomatic distresses of patients due to relational problems (16.3%) and intra-staff problems (2.3%).These problems were attributable to the following factors : personality problems of the patients (34.9%), organic mental disorders such as delirium and dementia (23.3%), inappropriate patient treatment by members of the ward staff (18.6%), patient adjustment disorders related to their physical disorder or admission stress itself (14%), and insufficient understanding and cooperation of the patients' family members (9.3%).The consultants utilized a solely patient-oriented approach in 10% of the cases, a strictly staff-oriented approach in 30%m and a combined-approach in 40%. In 20% of the cases, they could not, or did not, intervene. Some improvement was achieved in 60.1% of the consultation cases that had relational problems.Finally, the authors stress the importance of both devising a clinical setting which will effectively manage relational problems, and providing suitable training of consultants based on the psychodynamic aspect of assessment and treatment.
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  • Rikihachiro Kano
    Article type: Article
    1998 Volume 38 Issue 2 Pages 135-141
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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    First of all, the significance of philosophy of psychosomatic medicine, which is the anthithesis of the fragmented medicine at this day, is stressed. The dilemma between clinical work and research, with which consultation-liaisonists are confronted, are discussed and its meanings are clarified. The purpose is to point out that this dilemma may be a matrix for integrative work in both clinical work and research.Then, the twenty-year history of clinical practices of consultation-liaison psychiatry at the Tokai University Hospital is reviewed in terms of structured activities and unstructuered activities, and the current issues for consultation-liaison psychiatry to deal with are discussed. Three issues are claified ; 1) crisis management as a major clinical task in current consultation-liaison psychiatry, 2) deleterious effects of brief hospitalization by the current economic and regulatory forces, on the certain aspect of teh therapeutic processes in inpatient setting of general hospital where the staff work together to understand psychological problems of patients and communicate information to each other, 3) increasing importance of community consltation-liaison psychiatry that is prompted by shortened hospitalization. The possible treatment approaches toward these issues are proposed ; 1) educational approach to hospital staff, emphasizing on working with patient on informed consent which should be started before hospitalization and maintained during hospitalization, and fascilitating early refferal to consultation-liaisonists, 2) consultation-liaisonists' needs to learn psychotherapeutic techniques of crisis intervention at various levels such as individual psychology, inpatient unit group dynamics and family dynamics, 3) making an integrated treatment plan during hospitalization and maintaining to implement it after discharge. The conclusion is made by laying stress on that medical staff should make a change in their professional standpoint, that is that patient is an informed consumer and an active partner with medical staff.
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  • Mari Harada, Hiroaki Kumano, Shinobu Nomura, Tomifusa Kuboki, Hiroyuki ...
    Article type: Article
    1998 Volume 38 Issue 2 Pages 143-152
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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    This study was performed to evaluate the relationship between the test parameters and the clinical characteristics of 48 female patients diagnosed as anorexia nervosa or bulimia nervosa according to DSM-IV criteria.First, we evaluated the test parameters according to the type of symptoms. The patients were divided into three groups : Group ANR consisted of 13 anorexia patients with strict dietary restrictions, Group ANB of 24 patients with anorexia nervosa and bulimia, and Group BN of 11 patients with bulimia nervosa. Because the test parameters deviated widely within each group, the means were not useful for clinical evaluation.Second, cluster analysis was performed, which categorized the eating disorders into 2 groups (Group A and Group B), with all ANR patients in Group A, while ANB and BN patients divided into both Group A and Group B. Group B was characterized by negative behavior, and Group A was characterized by the feature of AN. The clinical features of the patients in Group A and Group B as determined by cluster analysis showed that suicidal attempts were significantly higher in Group B than in Group A.We revealed that ANB and BN patients who categorized Group B showed negative bahavior. So the low impulse regulation is not a feature of bulimia but of the patients of Group B.It was suggested that Group A showed the feature of nutreated patients of eating disorders.
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 152-
    Published: February 01, 1998
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    1998 Volume 38 Issue 2 Pages 153-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 153-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    1998 Volume 38 Issue 2 Pages 153-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 154-
    Published: February 01, 1998
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  • [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 154-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 154-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 154-155
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    1998 Volume 38 Issue 2 Pages 155-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    1998 Volume 38 Issue 2 Pages 155-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 155-156
    Published: February 01, 1998
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 156-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 156-
    Published: February 01, 1998
    Released on J-STAGE: August 01, 2017
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 156-157
    Published: February 01, 1998
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 157-
    Published: February 01, 1998
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 157-
    Published: February 01, 1998
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 157-158
    Published: February 01, 1998
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 158-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 158-
    Published: February 01, 1998
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  • [in Japanese]
    Article type: Article
    1998 Volume 38 Issue 2 Pages 159-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 159-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 161-
    Published: February 01, 1998
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  • Article type: Appendix
    1998 Volume 38 Issue 2 Pages 162-
    Published: February 01, 1998
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  • Article type: Cover
    1998 Volume 38 Issue 2 Pages Cover3-
    Published: February 01, 1998
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