The medial prefrontal cortex (PFC) and ventral tegmental area (VTA) are A_<10> systems of mesocor-ticolimbic dopamine system, which is pathophysiologically related to the model of drug dependence. Metamphetamine (MAP) was applied to examine the functional relationship between PFC and VTA in an animal of drug dependence. Hyperactivity and stereotyped behavior were observed accompanied by a distinctive direction of information flow. In hyperactivity "information flow" in the direction from PFC to VTA was dominant. Contrarily dominant "information flow" in the direction from VTA to PFC was found in stereotyped behavior. These results indicate that dysfunctional interaction between PFC and VTA is the neuronal basis of MAP-induced drug dependence. The "information flow" and its direction can be a useful tool to explain the pathogenesis of these abnormal behaviors.

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Recent medical developments in Japan have been astonishing. Especially in diagnosis and treatment technology, Japan ranks top-level in the world. Nevertheless, for such incurable conditions as "progressive cancer" and "terminal cancer", even with the highest possible level of medicine, care which is really adequate is not easily available. Patients with no prospects of recovery are often forced to stay alive as long as possible without receiving pain relief and adequate psychological care, and many end up dying a painful and lonely death. Being anxious to improve this situation, not only medical and nursing staff but also the general public have become increasingly interested in hospice/palliative care during the past two decades. In the 1970s, a small number of physicians began to develop a special interest in hospice care and they decided to initiate a team approach to the dying patient. The work of St. Christopher's Hospice in UK was reported in the newspapers and public interest in hospice intensified gradually. The first hospice facility was established in 1981. Within the last decade, gradual yet remarkable progress has taken place in perception of the need for palliative care services in Japan. In 1990 palliative care services in Japan entered a new era when the national government authorized medical insurance coverage for palliative care. Under a new insurance system which is applied only to those special government-approved Hospice and Palliative Care Units, a daily payment of 38,000 Japanese yen (US$ 310) is designated for each patient regardless of the cost. In 1996, the Japanese Society for Palliative Medicine was organized and members already number about 1,800. As of the end of August 2001, Japan has 89 Hospices and Palliative Care Units which have been established during a 20-year period. Although many difficulties have been encountered in establishing them, public and medical professionals have begun to recognize the importance of palliative care. Thus palliative care has the origin in hospice care. The definition of palliative care of WHO is as follows : "Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and psychological, social and spiritual problems is para. mount. The goal of palliative care is achievement of the best possible quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness, in conjunction with anticancer treatment."

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A variety of medicines, such as digestive medicines in addition to psychotropic drugs including anxiolytics, antidepressants, hypnotics, antipsychotropic drugs and mania state medical treatment agents may be prescribed to the patients with eating disorder. We observed from the pharmacist's view "Regarding the anxiety about medicine" in the pediatric patients with eating disorder through pharmaceutical care, and examined the role of the pharmacist as a member of therapeutic team for eating disorder. Very important roles of the pharmacist are as in the following: 1. Finding out complaints about medicines by listening to patients 2. Informing patients of "mutual understanding of the anxiety about medicine". 3. Making patients aware of "a pharmacist is always with you" and creating an environment under which patients can take medicines despite anxiety. These trials are good factors to strengthen their ability for self-expression.

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In Japan, to date, there has been no instrument available to measure perceived stress. The purpose of this investigation was to evaluate the reliability and validity of the Japanese Perceived Stress Scale (JPSS). The JPSS is a translated and modified form of the 14-item Perceived Stress Scale (PSS), a measure designed to assess the degree to which situations in one's life are appraised as stressful. We administered the JPSS and a life-event scale entitled the Social Readjustment Rating Scale (SRRS;Japanese version) to adult workers (General Sample) and patients in the Department of Psychosomatic Medicine at Tohoku University Hospital (Patient Sample). Along with examination of correlations between the JPSS and SRRS, in the Patient Sample we investigated the associations of the JPSS and SRRS with physical and psychiatric symptoms of Cornell Medical Index (CMI) and Depression scale of Minnesota Multiphasic Personality Inventory (MMPI). Results indicated that the coefficient alpha reliability for the JPSS was. 82 and. 89 in both samples. The mean JPSS score of the Patient Sample was significantly higher than that of the General Sample. Further-more, while the JPSS was correlated with SRRS life-event score in both samples, this correlation was significantly larger in the Patient Sample than in the General Sample. Additional analyses conducted in the Patient Sample indicated that the JPSS was more strongly associated with patient's psychiatric and depressive symptomatology than the SRRS life-event scores. In conclusion, the JPSS is suggested to be a reliable and valid instrument to measure perceived stress in Japan.

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The purpose of this study was to assess multiaxially school non-attendance students who were hospitalized at the department of psychosomatic medicine. On the basis of the assessment results, sex differences and age differences of psychopathological characteristics were examined. The subjects of the analysis included 67 school non-attendance students, hospitalized at the department of psychosomatic medicine. They were assessed according to the axis 1 (psychiatric disorders), the axis 2 (personality features and disorders), the axis 3 (general medical conditions), and the axis 4 (psychosocial and environmental problems) of DSM-III-R & DSM-IV. These results of the assessment were stratified in each axis after they were classified into one to eight categories. Next, age differences (junior high school group, high school group, and college group) of the number of diagnoses were examined in the axis 1 and the axis 4. Age differences of the existence of any diagnosis were examined in the axis 2 and the axis 3. In addition, sex differences of the number of diagnoses were examined in the axis 1 and the axis 4. Sex differences of the existence of any diagnosis were examined in the axis 2 and the axis 3. In the axis 1, the diagnoses of eating disorders, anxiety disorders, mood disorders were made in many cases (Since adjustment disorders were diagnosed in most of the cases, they were excluded from the analysis). In the axis 2, the diagnosis of immaturity, was found in many cases. In the axis 4, the diagnoses of family-related problems and bullying were made in many cases. In addition, some kind of diagnosis was made in 27 cases (40%) in the axis 2, and 26 cases (39%) in the axis 3. The college group had significantly larger number of diagnoses in the axis 1 than the junior high school group and the high school group (p<0.05, Kruskal-Wallis test. Mann-Whitney U-test following Ryan's procedure for multiple comparison tests). Some kind of diagnosis was given significantly more often in females in the axis 2 than males [p<0.05, χ^2-test (Fisher's exact test)]. Overall, psychopathological characteristics of school non-attendance students are diverse, and the non-attendance behavior cannot be attributed to a single cause. In addition, age difference and sex difference were also found in the results of multiaxial diagnosis. Therefore, school non-attendance students should be assessed multiaxially, and be treated individually.

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