Significant strides have recently been made in understanding and treating hypochondriasis. In particular, it has been conceptualized as a self-validating and self-perpetuating disorder of cognition and perception, and as a non-verbal form of interpersonal communication. Both of these conceptual models have important implications for medical management. They also serve as the basis for a focused, cognitive and behaviorally oriented treatment. This combination of improved medical management and cognitive/behavioral therapy gives us reason to be more hopeful about the course and outcome of this previously refractory and disabling condition.

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We made the Japanese brief version of the Short Interpersonal Reactions Inventory (SIRI) which aims at measuring the cancer-prone personality.At first, the SIRI was translated into Japanese, which was checked by a bilingual and back-translated by another bilingual. All personnel of a general hospital located in the center of the City of Sendai were asked to respond to the SIRI with some parallel tests, and 485 (of whom 92 were male and 393 female) out of 635 workers answered them.As a result of factor analysis, 4 factors consisting of 5 items each and consistent with the original scale were extracted (which explained 40.1% of total variance). The cancer-prone personality corresponds to the first factor. As a result of correlational analysis with some parallel tests, the first factor was assumed to measure 'harmony seeking' which might be more influential to the occurrence of cancer than the ohter major trait of cancer-prone personality named 'rationality/anti-emotionality'. Furthermore, it was indicated that the Japanese brief version of the SIRI could discriminate 4 personality types by comparing standardized scores of 4 subscales.It was concluded that a brief questionnaire was developed which can measure a personality trait mainly composed of 'harmony seeking' assumed to be profoundly influential to the occurrence of cancer.

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To investigate the necessity of a team approach for patients with eating disorder, we evaluated the relationship between how to decide the inpatient management and prognosis as well as evaluating the relationship between the responses of doctors or nurses to deceptive behavior during behavior therapy and prognosis.The patients who decided to be hospitalized because of the strong recommendations from family members showed lower global clinical scores (GCS) than those who decided by themselves (p<0.05). During behavior therapy, the patients who evaluate the responses of doctors to deceptive behavior as firm, those of nurses as supportive showed low GCS (p<0.05). Sixty percent of patients replied that their experiences during inpatient management were helpful to control eating habits after discharge.Strong persuation from family members was necessary when the patients decided to receive inpatient management.Moreover, firm response of doctors as well as neutral and supportive response of nurses to the deceptive behavior during behavior therapy were necessary.These results suggest that a team approach is a very influential factor to prognosis.

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The present study was made to classify recent techno-centered tendency in which was observed some new qualities.Seven hundred & eighty computer operators were asked to complete a questionnaire to evaluate techno-centered stress. The questionnaire consisted of 23 questions which were made of 7 new questions added to 16 questions of our previous study. Of 780 subjects, 571 responded. Among them, 118 subjects, who had been operating computers for more than a year and were evaluated to have high techno-centered tendency by the questions of our previous study, were selected. Each question of the questionnaire was given the following point according to the answers : Yes=1,Unknown=0.5,No=0. Factor analysis was conducted to classify the questions.With the factor scores, further analysis was conducted by cluster analysis.As the result of factor analysis, the following 6 categories were obtained (cumulative proportion : 60%, eigenvalue : factor 1=2.89,factor 2-1.98,factor 3=1.62,factor 4=1.48,factor 5=1.25,factor 6=1.17) : I Addiction to associating with other people in computer environment, II Difficulty in returning to daily environment from computer environment, III Absorption in operating computers, IV Lack of interest in anything except computers, V Extreme requirement of rationality, VI Lack of cooperative nature. Cluster analysis showed that I and II were similar and that the cluster of I & II was similar to VI. It was also shown that III and IV were similar and that the cluster of III&IV was similar to V.Categories II〜VI shows qualities which have been identified to describe techno-centered tendency. It is indicated that those categories are the main factors to describe techno-centered tendency. Category I shows a new quality and it is suggested that I is identified as a new factor to describe techno-centered tendency.

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A 26-year-old woman was referred due to intractable atopic dermatitis (AD), which had recurred after the remission for 10 years. At that time, she was continually on the move despite skin symptoms, as if she had no need to be aware of her negative feelings. She was self-reliant and tended to suppress her desires and feelings. It seems that she had learned this inadequate model under the influence of her moralistic parents. We thought this model constituted the preparation stage for her recurrence. Because it is necessary for her to be introspective, she was admitted to hospital and treated with counseling, diary therapy, and autogenic training. They facilitated her to understand psychosomatic correlations, to modify her distorted perception and inadequate behavior, and to learn a new mode of adaptation. Consequently, the preparation stage for her recurrence decreased and her skin disorder steadily improved.

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A 15-year-old junior highschool girl who developed anorexia nervosa with pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema.At her first visit to hospital, her body weight was 34.5kg(BMI 13), and 7 days later reduced to 29.5kg(BMI 11.1). At that time, radiographical examination demonstrated air in the mediastinal, retroperitoneal and subcutaneous space. Blood coagulation test showed pre disseminated intravascular coagulation. She was immediately hospitalized.Rested in bed and infused gabexate mesilate, her blood coagulation test normalized 1 week after, soft tissue emphysema diminished 3 weeks after.Soft tissue emphysema is considered to occur by weakness of soft tissue from malnutrition.So, when weight was lost within a short time, we have to pay careful attention to the anorectic patient, because severe complications are suspected to occur.

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The number of patients suffering from eating disorders (ED) is increasing in Japan and in advanced countries. Most patients with ED are unmarried young women who desire to lose weight, or women who have a fear of getting fat. ED patients also have a strong belief that they are healthy and that they are not suffering from a mental or a physical illness. Recently, the number of married women with ED has been increasing. In this paper, we report the case study of a 39 year old married woman suffering from ED.The patient has been gradually losing weight since she had caught cold 3 years ago. When she was brought to the hospital by her family against her will, she was unable to perform any tasks due to severe malnutrition. At the time of admission, her weight was 26.4 kg (height 162 cm and BMI=10.1). Medical examinations indicated that the patient did not suffer from an organic disorder, depression, schizophrenia, or a body image disturbance. She was diagnosed as suffering from ED.Her developmental history made it clear she believed that she was neglected and unloved by her parents because she was a female. She felt that her parents took better care of her brother because he was to inherit their father's business. Her developmental history (sibling rivalry) resulted in denial of her self-esteem.The patient had a history of habitual shoplifting. Even though she wanted to stop this habit, she was unable to do so. She was unable to talk about this problem with other people. She was lonely and suffered from feelings of guilt associated with shoplifting. She had a need to be punished for her evil acts and felt that not eating would result in weight loss and ill health and that ill health would atone for her shoplifting.We believe that her desire for ill health was the cause of her ED.During therapy, we advised her to speak out her feelings to her family because we considered that this would reduce the feelings of guilt associated with shoplifting. According to our advice, she confessed her shoplifting and her desire for self punishment. Her family accepted her confession uncritically (she had family support), and as a result her desire for self punishment decreased. Following this experience, she was able to eat again and her body weight gradually increased to 38.4kg. She was discharged from hospital after 4 months of treatment.

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