We examined the discriminant validity of the Japanese brief version of the Short Interpersonal Reactions Inventory(SIRI 33) which aims at measuring the cancer-prone(type C)personality. The SIRI 33 was answered by 30 lung cancer and 10 alimentary tract cancer patients. There were 9 subjects of type 1(harmony seeking)and 16 subjects of type 5(anti-emotional)personality which constitute type C pernonality out of 40 patients, and their appearance rates were significantly higher than that of sex and age-matched healthy controls. On the other hand, there was no patient of type 2 personality corresponding to ischemic heart disease-prone personality, and there were only 4 patients of type 4 personality which is a characteristic of autonomous and healthy individuals. In addition, there were more type 1 than type 5 subjects in younger patients as reported before. There were 7 type 1 and 5 type 5 subjects while there were no type 2 nor type 4 subjects out of 17 patients under the age of 65. Thus, it can be concluded that the discriminant validity of the measurement of type C personality using the SIRI 33 was proved.

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Our studies attempted to assess coronary-prone personality in Japan by using a broad spectrum inventory system, Japan Mental Health Inventory(JMI). JMI was administered to 79 middle aged males with ischemic heart disease and 147 healthy male workers. JMI is a questionnaire with 596-items which is based on four scales comprising body scale, mental scale, personality scale and work environment scale. First, factor analysis was performed on particular terms of JMI that had different answer percentages between the ischemic heart disease group and the reference group. Secondly, discriminant analysis was performed. Lastly, cross-validation was done with other samples of 64 patients with ischemic heart disease and 927 healthy male businessmen. We found 10 factors that were useful for discriminating between the two groups. Especially, anger-hostility and impatience factors which replicate the factors of type A behavior pattern gained higher discriminant function loading. However, the factor of adaptation to work was lower in the ischemic heart disease group. This finding was inconsistent with other Japanese studies presented in this field.

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The purpose of this study was to develop the Japanese version of "the Nottingham Adjustment Scale(NAS)" which measured psychological adjustment to the visual impairment, and to assess its validity and reliability. The NAS is composed of 7 psychological subscales including anxiety-depression, self-esteem, attitude to disability, locus of control, acceptance of disability, self-efficacy and attributional style. First, we translated the original questionnaire into Japanese after obtaining the author's approval. Next, We translated the Japanese rendering into English again, and asked the author to confirmed it. This Japanese version was called "the NAS-J(the Nottingham Adjustment Scale Japanese version)". The items of the NAS-J were selected through the pretest with sighted people. Then we conducted a survey of visually impaired people who were engaging in vocational training in 5 national rehabilitation centers. A total of 336 persons were asked to fill out the NAS-J and the SF-36(Health-related QOL scale), and primary diseases inducing visual impairment, eyesight, and the number of years since the present sight became stable were also inquired. As a result of factor analysis, 31 items were retained and 7 factors consistent with the original scale were extracted(51.6% of total variance). Each items contributed 0.5 or more loadings to a supposed factor, and contributed 0.5 or less loadings to the other factors. These results showed the sufficient construct validity, convergent validity and discriminant validity. The subscales of anxiety-depression and self-esteem significantly correlated with most subscales of the SF-36 in sighted people, and thus the concurrent validity was shown. The scores of visually impaired people were lower than those of sighted people in 4 subscales such as anxiety-depression, self-esteem, attitude, and locus of control as the earlier study, and the discriminant validity was confirmed. The reliability coefficients of all subscales were more than 0.7 except that of locus of control. Because the number of items of locus of control was rather small, the reliability coefficients of the subscale was permissible. These results showed the sufficient validity and reliability of the NAS-J as the scale which measures the psychological adjustment to visual impairment. We are constructing the structure model of the psychological adjustment and investigating the effects of the adjustment to handicap. We will publish these results on another occasion.

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The purpose of this study was to investigate the psychiatric comorbidity(depression and panic disorder), stress coping styles and personality traits in a general population with migraine. The prevalence of migraine in 300 college students was assessed by the questionnaire of headache. Comparisons were made among the groups with migraine with aura, with migraine without aura, with other headaches and with no headache on the SRQD, questionnaire of panic disorder and LHQ. Among those 300 students, 24% of them have had migraine all their life. 20 migraine students(28%)fultilled the DSM-IV criteria for major depression and 24 migraine students(33%)for panic disorder. Especially the group with migraine without aura showed a significant association with psychiatric comorbidity than other groups with headaches or without headache. Compared with the group of no headache, the group of migraine without aura demonstrated a high tendency of active coping behavior under stents. Compared with the group of other headaches and the group of no headache, the both groups of migraine were characterized by their vulnerability to time pressure.

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Though diabetes mellitus is a very common disease, no cure for it has been established. Investigations have shown that lifestyle factors provoke non-insulin dependent diabetes mellitus(NIDDM) in people with certain hereditary factors. As the main treatment of diabetes mellitus involves self-management, most patients have to change the lifestyle to which they are accustomed. They have to manage their daily activities, including food intake, exercise and taking medicine or insulin injections regularly throughout their lives. Some patients can change their lifestyle relatively easily to improve their health, but others find it so difficult that they became depressed. The author thinks that a person's lifestyle is created by adjusting to various environmental factors, and that the, lifestyle is inseparable from "the way of life". Recently, it has been reported that psychological support of patients with diabetes mellitus is necessary for good glycemic control. The author thinks that psychological management of adolescent patients with diabetic mellitus should be based on a whole-person approach including depth psychology, because the physical condition of patients with NIDDM is closely related to how they live their lives. The author conducted psychotherapy on a male patient in his 50's with NIDDM. He had suffered from NIDDM for more than 30 years and had developed proliferative diabetic retinopathy. The method of therapy was simple, in which the therapist listened carefully to the patient's narrative with deep symputhy. When rapport was established, the patient began to talk about his negative feeling toward the disease and its treatment. After that, he talked about his wife who had been suffering from depression for several years. Subsequently, the patient suffered from several injuries, such as a fissured fracture, a cat bite, and muscle injury by hard exercise. These events were thought to be "acting out". It was noteworthy that glycemic control became stable while the "acting out" occurred. This would suggest that improved mental stability led to stable glycemic control. As the patient became aware of his aggression, he tried to manage it by himself in his daily life. This report shows the importance of listening to the narratives of patients with chronic diseases such as diabetes mellitus.

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For nearly 20 years, the author has conducted studies and made numerous attempts to promote spontaneous regression of cancer by a holistic approach he uses for psychoneuroimmunopathology. His treatment with his method has been done largely by repeated trial and error. Other investigators, notably O.C.Simonton and S.E.Lock, have also reported good results in this regard. In recent years, there have been tremendous improvements in pharmacology for treatment of cancer patients. However, it should be recalled that the critical factor, that is the key to the treatment, is above all the patient's "will to live." Thus, the pharmacology and psychotherapy must be well balanced to assure the success of the protocol. Immunology, research on psychoneuroimmunopathology, mental state and its treatment, along with DHEA etc., must be carefully coordinated. Terminal care today is woefully insufficient, and the present study represents an initial attempt based on the author's long experience.

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