[in Japanese]

View full abstract

Energy homeostasis is accomplished through a highly integrated and redundant neurohumoral system. Recently, novel peptidergic regulators for feeding and body weight regulation have been identified in the hypothalamus of brain and the periphery. Because of the multitude and complexity of disturbances in energy intake, expenditure, and partitioning that are associated with obesity, cachexia and eating disorders, it has been difficult to determine which abnormalities are causative versus less important phenomena that are consequences of the altered neuroendocrine and metabolic milieu. Transgenic technology has provided new opportunities to modify the complex body weight-regulating system and to assess the relative importance of the individual components. For example, modest overexpression of neuropeptide Y (NPY) in the brain led to the anxiety-like behavior involving corticotropin-releasing factor (CRF) , as well as resistance to amphetamine-induced feeding suppression and obesity after high-sucrose feeding. This may suggest a pathogenetic role of NPY in feeding abnormalities and is consistent with the hypothesis of unbalanced shift of feeding-regulatory circuitry, i. e. excess of both feeding-stimulatory (orexigenic) and feeding-inhibitory (anorexigenic) signalling, which places anorexigenic CRF and orexigenic NPY in the final common neurobiological substrate for anorexia nervosa. Observations of mutant mice have thus shed new light on the understanding of energy homeostasis equation and its abnormalities. Once created, transgenic animal models may be useful in analyzing the impact of diet, stress and other environmental exposures, as well as in assessing the efficacy or determining the mode of action of potential new therapeutic agents.

View full abstract

Objective : To clarify the relationship between somatic symptoms and bradykinin concentrations in patients with mental disorders. Methods : Bradykinin levels were determined in 95 patients diagnosed as one of the following mental disorders : schizophrenia (n= 8) , major depressive disorder (n=22) , anxiety disorders (n=46) , somatoform disorders (n=14), eating disorders (n=3) and premenstrual dysphoric disorder (n=2). Circulating bradykinin was measured using a radioimmunoassay technique (normal values : < 10.0 pg/ml) . Results : High bradykinin levels were observed in patients with all of the mental disorders examined. The mean plasma bradykinin concentrations for each group were : 73 pg/ml for schizophrenia, 135 pg/ml for major depressive disorder, 108 pg/ml for anxiety disorders, 110 pg/ml for somatoform disorders, 87 pg/ml for eating disorders and 124pg/ml for premenstrual dysphoric disorder. The patients with bradykinin levels> 100pg/ml (n=43) that were more than tenfold above normal values complained of at least three of the following symptoms : stiffness of the shoulders and neck, visual blurring, chills or hot flushes, abdominal discomfort, shortness of breath, fatigue, disturbed sleep with nightmares, and palpitation. Conclusions : The sera of patients with diverse mental disorders patients showed the presence of hyperbradykininemla. The symptoms reported by these patients might therefore be explained by the properties of bradykinin, which functions in pain production, vasodilation, the synthesis of prostaglandins and increased the blood-brain barrier permeability in conjunction with other biogenic amines.

View full abstract

We developed a new technique using pictures modified by personal computer to evaluate the body image of eating disorder patients. To investigate means the validity of this method, we evaluated normal controls' and eating disorder patients' body image by means of their modified pictures. The participants (all women) included 34 normal controls and 25 eating disorder patients (14 with anorexia nervosa [AN] and 11 with bulimia nervosa [BN] ) . The horizontal dimension of their pictures taken by digital camera, was expanded (to 105%, 110%, 120%, and 140% of normal) and contracted (to 60%, 80%, 90%, and 95% of normal). Then the participants were asked to select the picture that approximated their perceived body image and their ideal body image. As to perceived body image, normal controls and AN patients selected correctly, but BN patients selected images that were more obese than their real body image. As to ideal body image, normal controls selected images that were thinner than their real body image, AN patients selected images that were no thinner than their real body image, and BN patients selected images that were thinner than normal controls' ideal body image. These findings suggest that normal controls desired to be thin, BN patients had a stronger desire to be thin and a greater feeling of being fat than normal controls, and AN patients were satisfied with their real body image.

View full abstract

The purpose of this study was to develop and validate the Japanese version of Social Phobia Scale (SPS) and Social Interaction Anxiety Scale (SIAS). The SPS assesses fear of being scrutinized during performance in the presence of others, while the SIAS assesses fear of social interaction. Six-hundred and fifteen undergraduate students and 21 outpatients with soclal phobia completed the SPS and the SIAS. Exploratory factor analysis revealed that the SPS included 20-items loading on one factor, which was named "Fear of being scrutinized" and the SIAS included 20-items loading on two factors, which were named "Soclal interaction anxiety" and "Deficit of _self-efficacy In social interactive situation". Internal consistency of both scales were sufficiently high (SPS : α=0.91. SIAS : α=0.72-0.92) . Results of t test revealed that patients with social phobia showed higher scores than undergraduate students for both scales. Therefore, it was concluded that the SPS and the SIAS have high discriminant validity. The SPS and the SIAS correlated moderately with other self-report measures of social anxiety. Furthermore, the SPS and the SIAS predicted anxious response to speech situations. It was suggested that the SPS and the SIAS have high validity and potential for clinical and research application. Finally, the efficacy of these scales for evaluating subtypes of social phobia was discussed.

View full abstract

We prepared a questionnaire that included five items to evaluate the family function from the child's viewpoint. We investigated the influence of family environment and upbringing methods on the family f unction. The subjects included 199 patients (average age \vas 21 years old) who consulted our department of psychosomatic medicine and 431 healthy students (average age was 20 years old) . We used factor analysis and logistic regression to analyse their responses to our questionnaire. The reliability of five items was 0.74 in Chronbach's α coefficients. The child-evaluated family function was scored 0 to 10. We considered that scores less than 3 as indicative of poor family function 4 to 6 for slight family dysfunction and scores more than 7 for good family function. The rates of poor family function were higher in patients with psychosomatic diseases (24%) than in healthy students (8%) (p<0.0001). Risk factors of poor family function are as follow : (1)physical violence by the father to mother, (2)physical violence by the parents to the child, (3)fear of parents, (4)divorce, separation, or death of parents, (5)lack of love from parents during childhood, and (6)parental neglect. The corrected relative risk of subjects who have one factor was about 5 times, two factors was 13 times, three factors was 15 times and more than four factors was 18 times compared to the subjects who had none these factors. These results suggest that it is very important to evaluate the family function from the child's viewpoint and our questionnaire is simple and useful for routine clinical use.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract