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Article type: Cover
2002 Volume 42 Issue 9 Pages
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Article type: Cover
2002 Volume 42 Issue 9 Pages
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Article type: Index
2002 Volume 42 Issue 9 Pages
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[in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
565-
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Article type: Appendix
2002 Volume 42 Issue 9 Pages
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Article type: Appendix
2002 Volume 42 Issue 9 Pages
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Article type: Appendix
2002 Volume 42 Issue 9 Pages
568-569
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Article type: Appendix
2002 Volume 42 Issue 9 Pages
570-571
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[in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
573-
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Takehiro Nozaki, Takayuki Yoshimura, Hideyo Sugahara, Hiroshi Kawata, ...
Article type: Article
2002 Volume 42 Issue 9 Pages
575-584
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We studied prospectively the relationship between the types of depression and the outcome. Subjects were recruited from outpatients visiting for the first time the Department of Psychosomatic Medicine, Kyushu University Hospital from December 1, 1999 to May 31, 2000. One hundred and fifty-seven patients met the DSM-IV diagnosis criteria of major depressive disorder, dysthymic disorder, adjustment disorder with depressive mood and depressive disorder not otherwise specified. Of these, 65 patients adequately completing treatment during the 6 months were available. We conducted follow-up evaluations at 1, 3 and 6 months after the baseline assessment using Hamilton Depression Rating Scale (HAM-D) and Zung Self-rating Depression Scale. All types of depression showed clinically significant decreases on the HAM-D scores at 3 months after and further improvements at 6-month follow-up. We discussed the meaning of treating depressed patients at the department of internal psychosomatic medicine.
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Osamu Miki
Article type: Article
2002 Volume 42 Issue 9 Pages
585-591
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Recently it is well known that depression is increasing in primary care, which is expanding the opportunity of the depressive patient's consultations. The object of this study was to clarify the clinical feature of depression in new patients (1997-2000) who visited the department of psychosomatic medicine at our clinic (n=330). We regarded the patients who chiefly complained of depressive symptoms, or who scored more than 45 points in self-rating depression scale (SDS) as the depressive symptoms group. This group occupied 48.7% (161 cases) in all cases. Depressive disorders (DSM-VI) were detected in 62.7% of the depressive symptoms group (n=161). In the classification of depressive disorders, major depression was detected in 21.7%, depressive disorder not otherwise specified in 73.2%, and dysthymic disorder in 4.9% of the patients. Regarding which department where the first medical consultation was made in the depressive symptoms group, the most frequent one was internal medicine (64.7%), which was followed by gynecology (9.5%), neurosurgery (8.4%) and psychiatry (5.6%). Diagnoses made at the first consultation included gastrointestinal diseases (23.4%), vegetative disorders (15.7%), stress reaction (12.5%), and depressive disorders (10.5%). Prognosis after 6 months in depressive disorders showed the remission rate of 52.8% in major depression, 62.9% in depressive disorder not otherwise specified, and 33.3% in dysthymic disorder. Depressive symptoms are very common in primary care. Therefore the doctors of primary care, including psychiatrists as well as non-psychiatrists, should identify depressive patients at the first consultation and treat them properly.
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Article type: Appendix
2002 Volume 42 Issue 9 Pages
591-
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Hirotaka Kashiwase
Article type: Article
2002 Volume 42 Issue 9 Pages
593-600
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The author examined the treatment algorithm of depression both in the United States and in Japan. In the United States' algorithm, how to use each SSRI properly in the clinical practice is unclear, and in Japanese algorithm Sulpiride, which is not in the United States' algorithm, is presented. In the United States after tricyclic antidepressant therapy SSRIs and SNRIs have been introduced into the market, while in Japan tetracyclic antidepressants, Sulpiride and Trazodone have been introduced. In both the United States' and Japanese algorithms, the author pointed out that although severity of depression is considered, symptoms and age of onset of depression are not taken into consideration. Severe, prolonged or mild depressions are important in clinical practice today. Very mild and geriatric depressions are also important. In Japan, the number of clinics of psychiatry or psychosomatic medicine has been increased rapidly. Very mild and geriatric depressive patients tend to visit those clinics nowadays. The geriatric patients with depression, first of all, tend to visit primary care physicians. Primary care physicians, therefore, should know how to diagnose and treat geriatric patients with depression.
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Daisuke Ohta, Nobuyuki Murabayashi, Koji Tsuboi, Koichi Nakano, Keigo ...
Article type: Article
2002 Volume 42 Issue 9 Pages
601-607
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We experienced a 60 year-old female case, who had suffered from the advanced gastric carcinoma. The patient had not been informed of her disease to be malignant, and her family had never wished to tell her the truth. The worse her general condition became, the more her anger was expressed to the doctor in charge or nursing staff. She had doubts on the therapeutic course which had brought her no improvement and demanded to tell the truth. Safe topics dominated between her and her family member's, and serious talks were avoided. Considering such a deadlock, the doctor in charge decided to inform her of her prognosis. As the result, her anger was decreased, which enabled her to have a good relationship with her family, the nursing staff or the doctor in charge. She was able to spend her remaining days with solid satisfaction. Furthermore, she offered to give her eyeballs to some one who needs them. Her wish was fulfilled after her death. In clinical settings of Japan, there often exists the difference of opinions between patients and their family members regarding whether or not they should tell the truth to patients. Under such situations, doctors in charge are asked to make right judgment on the wish of patient and family and to take a role of bridge between them. This intervention would enable patients to spend their remaining days more satisfactorily.
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Masako Kaku
Article type: Article
2002 Volume 42 Issue 9 Pages
609-613
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I encountered two girls with "handedness involuntary movement" who were diagnosed as having a conversion disorder, and treated by psychotherapy. They had histories of sexual abuse. Patient 1 was 13 years old. Six months after psychotherapy was started, she told her mother that she had been forced to lend a hand to masturbate her mother's lover during the time between the ages of 10 to 12. Patient 2 was 15 years old. She was suspected of having a history of sexual abuse because her disorder was similar to Patient 1. When asked whether she had been sexually abused, she responded that she had also been forced to masturbate. The "handedness involuntary movement" in these two patients was considered to have been caused by being forced to masturbate.
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[in Japanese]
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2002 Volume 42 Issue 9 Pages
613-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
615-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
615-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
615-
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[in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
615-616
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
616-
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[in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
616-
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[in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
616-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
616-617
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
617-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
617-
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[in Japanese], [in Japanese], [in Japanese]
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2002 Volume 42 Issue 9 Pages
617-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
618-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
618-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
618-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
618-
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[in Japanese]
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2002 Volume 42 Issue 9 Pages
619-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
619-
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[in Japanese]
Article type: Article
2002 Volume 42 Issue 9 Pages
619-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
621-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
621-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
621-622
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
622-
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Article type: Article
2002 Volume 42 Issue 9 Pages
622-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
622-623
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2002 Volume 42 Issue 9 Pages
623-
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Article type: Article
2002 Volume 42 Issue 9 Pages
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2002 Volume 42 Issue 9 Pages
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Article type: Article
2002 Volume 42 Issue 9 Pages
623-624
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[in Japanese], [in Japanese]
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2002 Volume 42 Issue 9 Pages
624-
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Article type: Article
2002 Volume 42 Issue 9 Pages
624-
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2002 Volume 42 Issue 9 Pages
624-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2002 Volume 42 Issue 9 Pages
624-625
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Article type: Article
2002 Volume 42 Issue 9 Pages
625-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
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2002 Volume 42 Issue 9 Pages
625-
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