The purpose of this study was to investigate the influences of subjective symptoms of attack in daily life on quality of life (QOL), fear of attack, and agoraphobic symptoms in paroxysmal atrial fibrillation patients. Subjects were 101 paroxysmal atrial fibrillation patients (73 males and 28 females), who were requested to perform a set of questionnaires on subjective symptoms of attack, fear of attack, agoraphobic symptoms and QOL. Results of regression analyses and path analysis revealed that the influences of subjective symptoms of attack on QOL were mediated by fear of attack and agoraphobic symptoms in the following way : a) frequency of atrial fibrillation affected fear of attack, b) duration and distress of atrial fibrillation affected agoraphobic symptoms, c) fear of attack affected agoraphobic symptoms and somatic QOL, d) agoraphobic symptoms affected somatic QOL, e) contraction period of atrial fibrillation directly affected somatic QOL. Finally, the importance of treatment of anxiety in atrial fibrillation patients were discussed.

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Autonomic nervous system dysfunction is often observed in patients with anorexia nervosa. Recent studies have revealed that the ratio of neutrophils to lymphocytes (N/L ratio) in peripheral leukocytes is under the control of the autonomic nervous system. In the present study, we investigated the relation between N/L ratio and the function of autonomic nervous system, estimated by use of microvibration in anorectic patients. Multiple regression analysis was performed to clarify the effect of the autonomic nervous system before treatment on the N/L ratio in female patients with restricting type anorexia nervosa. The results were as follows : 1) the N/L ratio was significantly lower than in normal controls. 2) the ratio had a significantly higher correlation to the increase of energy % of the microvibration β band. These results suggest that the predominance of lymphocytes in peripheral white blood cells in restricting anorectic patients was caused by parasympathetic nerve stimulation.

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The purpose of this survey is to reveal the actual number of patients with eating disorders and the actual state of treatment in Japan. We conducted investigations at 12 medical facilities in Niigata, Hyogo, Hiroshima, Fukuoka, Ohita and Kagoshima prefectures from September 15 to December 14 in 1997. Subjects completed the questionnaire. The number of people diagnosed as eating disorder was 358, in which the number of AN, BN and EDNOS was 178 (49.7%), 112 (31.3%) and 68 (19.0%), respectively. The ratio of male to female was 1 to 34.8. The average of percentage of standard BW was 67.5% in AN patients and 96.8% in BN patients. The mean age at survey was 22.7 years old. The number of patients who were over 30 years old was 59 (16.4%). The mean age at onset was 18.6 years old. The number of patients whose onset age was below 15 years old was 85 (25.0%). The average of duration of illness was 51.1 months. The number of patients who suffered more than 5 years was 95 (26.5%) ; and that of more than 10 years was 42 (11.7%). The average of duration of illness in the purging type was 64.0 months and that in non-purging type was 29.3 months. The percentage of standard BW of the purging type was 81.1% ; the non-purging type was 74.7%. There were significant differences between these tow groups (p<0.001). As a conclusion, it is necessary to establish medical institutes to treat eating disorder and the rehabilitation system to improve social adaptation of patients.

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Although the number of older people over 65 years old has rapidly increased in Japan, few psychosomatic studies on older people have been reported so far. The authors conducted psychosomatic examinations of older people with multiple somatic complaints who were staying at a nursing home in Tokyo. We got the following results. 1) The diagnoses of those cases include neurosis or "neurotization". No case was diagnosed as solely psychosomatic disorders without neurosis. 2) It is suggested that those cases with multiple somatic complaints will become hardly demented. 3) There were no cases who developed psychosomatic disorders for the first time in the old age. They had psychosomatic disorders already in their younger age. 4) Not only psychosomatic therapy but also somatopsychic therapy were considered to be useful for the treatment of the patients with multiple somatic complaints.

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As psychosomatic medicince is being known to the public, an increasing number of patients with mild psychosomatic symptoms such as seen in mild depression or an early stage of schizophrenia receive their first medical examination at psychosomatic hospitals. From 1984 to 1997, to our Goryokai Hospital which is a psychiatric hospital 226 patients were referred from Sapporo Meiwa Hospital which professes as a psychosomatic hospital. Ninety-four patients were male and 132 were female. The age at the time of referral to our hospital ranged from 15 to 84 years old (mean 35.2). 90 (39.8%) of these patients had psychotic symptoms and 64 (28.3%) had depressive symptoms. Clinical diagnoses of these patients included schizophrenia (74 cases, 32.7%), affective disorder (78 cases, 34.5%), neurosis (27 cases, 11.9%), personality disorder (18 cases, 8.0%) and eating disorder (9 cases, 4.0%). 135 (59.7%) of these patients were hospitalized and the average length of hospitalization was 103 days. After hospitalization, 58 patients became out-patients, 34 terminated treatment, 17 were introduced to other psychiatric hospitals and 4 (all schizophrenia) required long-term hospitalization who couldn't be discharged from the hospital. This study suggests that many patients who need psychiatric treatment receive then first medical examinations at psychosomatic hospitals because of their prejudiced view of the psychiatric hospital or their ignorance of the role of psychiatry and psychosomatic medicine. This situation suggests that psychosomatic hospitals need to build up a closer working relationship with the psychiatrist.

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Two cases are both females. Case 1 is 56 years old, and Case 2 is 28 who were diagnosed as interstitial cystitis. Only Case 1 had associated bladder pain. We used the frequency/volume chart to make clear one's pathology. In Case 1, the interval of voiding time and the voided volume were almost equal. In Case 2, there was some nocturia and the voided volume was variable. These results showed that Case 1 had organic disorder as its major pathology, and Case 2 had a functional disorder. As for the treatment, hydrodistension was effective in Case 1, and bladder training in Case 2. Interstitial cystitis has the mixed pathology of organic and functional disorder. The frequency/volume chart and the presence of bladder pain help us to understand the major pathology and treatment of interstitial cystitis. With regard to a case which seems to be a functional disease, we need to differentiate interstitial cystitis from chronic pain disorder or psychogenic urgency-frequency syndrome.

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