It is well-documented that the development and progression of cancers is affected by psychosomatic factors, and also that the quality-of-life of cancer patients is improved by intervening these factors. Based on this concept, we analyzed 50 patients with breast cancer and 24 healthy females as a control by means of psychological inventories such as Todai Egogram (TEG), State-Trait Anxiety Inventory (STAI), Minnesota Multiphasic Personality Inventory (MMPI), and MMPI-Alexithymia Scale (AS), and interview.The results indicate higher measures in anxious and alexithymia scales in the patients. Paradoxically, however, their behaviors to suppress their emotion, to co-operate well, and to adapt excessively were recognized by interview.From these results, the patients with breast cancer are assessed to share factors characteristics of "type C" personality.

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Peptic ulcers have been considered as one of typical psychosomatic diseases. Since the participation of Helicobacter pylori (H. pylori) in them has been reported, however, ulcers became to be regarded as one of infectious diseases. Our purpose was to find how psycho-social factors contribute to the occurrence and recurrence of ulcers. This study was examined on totally 94 persons. The ulcers group consisted of 54 persons, and 12 of them were the patients who had ulcers for the first time and 42 were those who had recurrent ulcers. The non-recurrent ulcer group consisted of 17,who had ulcers in the past but have not at present, and the non-ulcer group consisted of 23 who have no ulcers both in the past and present. None of those had medical treatment for eradication of H. pylori.We interviewed them and surveyed their psychological and social backgrounds such as smoking, drinking, dietary life, personality, daily stress and stress-coping, etc. We obtained their answers for MMPI, one of psychological tests and SSRS, the questionnaire on their life events. We also conducted blood examination and measured serum antibody value of anti-H. pylori IgG (HP antibody) and serum pepsinogen I (PG I). Consequently, we obtained various factors related to the occurrence and recurrence of ulcers.First of all, we made comparative examination among the ulcer group and the non-ulcer group, and the recurrent ulcer group and the non-recurrent ulcer group on each factor. H. pylori is regarded most important as the factor related to the occurrence and recurrence of ulcers. However, no significant differences on the positive rate of HP antibody were observed in both comparisons between the ulcer gorup and the non-ulcer group, and the recurrent ulcer group and the non-recurrent ulcer group from the result. Specific personality of the patients who have ulcers were not clearly observed. Similarly, no significant differences were observed also on stress and life events in both comparisons. The most marked differences in the comparison between the ulcer group and the non-ulcer group were found in the factors relating to behavioral science.Rate of smoking people was significantly higher in the ulcer group than in the non-ulcer group. More drinking and less stress-coping were observed more often in the ulcer group than in the non-ulcer group.Dietary irregularity was an important factor in recurrence. We than perfomred multivariate analysis to examine what factor is most important in the occurrence and recurrence of ulcers. As the result, it was suggested that the factors of behavioral science such as smoking, stress-coping, and dietary irregularity etc.play a more important role in the occurrence and recurrence of ulcers than H.pylori.We consider it important to prevent the occurrence and recurrence of ulcers caused by psycho-social factors by continuing psychosomatic approach to peptic ulcers.

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We reported a 13 year-old gril with orthosatic hypotension (immediate type) associated with school absenteeism. The mechanisms responsible for her orthosatic hyotension were impaired noradrenaline secretion in the resistance vessels and excessive venous pooling in the lower part of the body during standing. The extent of orthostatic hypotension (immediate type) precisely evaluated by a non-invasive continuous circulatory measurement might be strongly influenced by her psychosocial backround including family relationship and unpleasant shool life. During five years after the onset o the illness, episodes of hypotension were repeated mainly associated with her emotional aggravation, but were improved by the psychosocial intervention. We emphasize that treatment of refractory orthosatic hypotension in adolescents should include psychosomatic and psychosocial intervention in the family relationship and school life.

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In eating disorders, there are not only mild cases, but also severe and/or prolonged cases. Therapies developed for the latter are controversial, but show promise as more cases of effective treatment are being presented.We report here a case of a 29-year old woman who has been suffering from anorexia nervosa hospitalized 10 times over a 10 year period. Whenever she lost weight, there was a trouble between her and her mother who was critical about her weight loss. To get away from her mother, she acquiesced to hospitalization. However, duriing her stay at the hospital when the weight gain raised her fear of getting fat, she would discharge herself from the hospital halfway through the treatment and rapidly lose her weight.She was very obsessive/compulsive and extremely anxious and resistant to changes that might lead to successful treatment of the disease, as she had been psychologically very dependent on the disease. In our outpatient clinic, we treated her with a focus on motivating her toward hospitalization for her own well-being. One year later, she accepted the hospitalization contract with a definite goal of inpatient therapy.We herein discus the relationship between obsessive/compulsivenes and the length and severity of eating disorders. The course of inpatient therapy of this patient will be reported in Report 2.

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We report here a case of a 29-year old woman. In out outpatient clinic, we treated her with a focus on motivating her toward hospitalization (ct. Report 1). Inpatient treatment was based on cognitive-behavioral therapy using behavioral restriction. The patient (1) repeated unresonable criticism of the therapist for perceived excessive restriction and made unreasonable demands for changes in her therapy in her therapy in the first stage of admission, (2) and then, continued her psychopathological habits and views and pursued excessive body weight gain, (3) complained of anxiety about restriction being lifted in the last stage. These attitudes and behaviors seemed to be caused by anxiety/resistance against change. We present in this report out therapeutic interventions and the process of her accepting change. We found the behavioral restriction to be very useful in the treatment of anorexia nervosa, but with some side effects if mechanically used, and herein report how to effectively utilize behavioral restriction.

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Relatively little has been written about pregnancy and delivery in anorexia nervosa. We reported a woman with active restricter-type anorexia nervosa who did not experience self-induced vomiting or purging, who bore 2 children.Her menarche was at the age 12 years, her menstrual cycle was discontinued by her food restriction at the age 15 when she was 155 cm tall, weighing 39 kg. She was admitted when she was 17 with her weight of 26 kg, for about 1 year and treated by behavioral and supportive psychotherapy. She recovered regular menstruation at the age of 18 with her weight of 47 kg, and married at 25.First, she delivered a live 2,076 g female by cesarean section, when she was 26,with her weight of 35.5 kg. Second, she delivered a live 1,814 g female at 30 with her weight of 32.5 kg. She breastfed her children.Amenorrhea has persisted from the age 30 to the present (35), during which time she weighed between 32 kg and 34kg. At the same time she had been complicated by obsessive-compulsive related symptoms.Although her daughters' development had no problem and they were very cheerful, she complained of easy fatigue, due to her restriction of food because of her fat phobia and to her obsessive-compulsive attitude toward life.

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