The aim of this study is to describe a new measure for screening to find a risk from the psycho-social aspects in postpartum women and to examine the reliability, validity and usefulness of this measure. A 48-item scale was constructed consisting of 7 types of items measured along a 5-point scale of intensity from 'Not at all' to 'Very much so'. A high score on the scale is indicative of a high level of concern. Data was collected from 804 postpartum women of the 3rd day after birth who delivered from October to December in 1995. Sixty eight subjects were excluded from the analysis due to missing data leaving a total of 736 subjects. The internal consistency of the questionnaire was evaluated using Cronbach's alpha and item statistics were ascertained. The range was from 0.730 to 0.847. The 48-item questionnaire was factor analysis using a principal components method with varimax rotation. Out of 13 factors with an eigenvalue > 1.0,7 high score factors emerged acounting for 47.7% of the variance were used. They were 'concern about household matters and childcare', 'psychosomatic fatigue', 'depressive tendency or emotional unstability', 'partner support' 'body Image' 'mental tensron' and 'anxiety for baby'. Factor scores of primiparas were significantly higher than those of multiparas in 'concern about household matters and childcare', 'depressive tendency', 'partner support', 'body image' (p<0.01) and in 'psychosomatic fatigue' (p<0.05). Also, factor scores of non-planned pregnancy were significantly higher than those of planned pregnancy in 'depressive tendency' and 'body image' (p<0.01). Results suggest that this questionnaire is a useful measure for screening in order to investigate maternal concern in postpartum from the psycho-social aspects.

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The patient was a 20-year-old female student studying at the faculty of educational studies in a university. Symptoms appeared during educational field training, starting with urinary retention (ischuria) followed by severe and diverse symptoms such as systemic spasm and quadriplegia. Any somatic disease to explain these symptoms could not be found, and in her background, poor development in acquiring ego identity was noted in the life cycle of the patient. After she was admitted to hospital and was subject to treatment, the patient became more anaclitic, and the symptoms were exacerbated. However, the symptoms were severe, and it was necessary to provide therapy in home care, which is not inferior to the treatment as inpatient. Thus, she was transferred to home care from hospitalization. Her own room was assumed to be hospital ward, examination by telephone interview and outpatient treatment to be as the visits of doctors, and her parents to be nurses, and this was named as home treatment. The patient gradually began to establish ego and the symptoms decreased. In the cases with conversion disorder who tends to aggravate when admitted to hospital, it seems more effective to perform treatment at home, which quite equals in quality the treatment as inpatient.

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We report the cases of Crohn's disease in siblings. Both of these brothers genetically had B 51 in their HLA, and psychologically they had workaholic life styles and over-adaptative characters in their workplaces and homes. We found the onset and clinical course of this disease were affected by psychosomatic factors rather than by genetic factors, and psychosomatic approaches were clinically effective in treating patients with Crohn's disease.

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