Japanese Journal of Psychosomatic Medicine

There are two big issues to be solved in relation to risk communications on the effect of electromagnetic fields in Japan. One is a deficit of the guidelines for extremely low frequency (ELF) electromagnetic fields (EMF), though ELF EMF is widely used and radiated in industrial settings with possibility for workers to be exposed above recommended values from ICNIRP. As a result, neither hazard information dissernination nor countermeasure to prevent excess ELF EMF exposure is taken for workers who are exposed to a high level of EMF. I would like to suggest for the government to issue the guidelines for limiting exposure to EMF lower than 10 kHz. Another point is regarding risk communication on the effect of very low level ELF EMF. An anxiety on the chronic effect (for example, cancer) of electromagnetic fields is increaslng with rapid development of electronic technology. With considering a classification result of ELF magnetic field as carcinogen 2 B under IARC program, risk communication on the chronic effect should be developed in order to prevent people from anxiety.

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The number of persons suffering from stress and stress-related disorders is increasing due to the rapid structural changes in socio-economic, educational and medical systems. While the social needs for psychosomatic medicine (PSM) have increased reflecting the era of changes, there are many issues to be resolved. I have introduced 4 themes and discussed from the viewpoint of further development of PSM. 1) Although several hypotheses regarding the etiology and concept of treatment for asthma have been proposed and changed during the past 4 decades, we had made continuously effort to study the mind-body connection and to improve psychosomatic treatment. We have reported the conditioned histamine release and involvement of hypothalamus in allergic reaction in animal experiments. In addition to these studies, we have demonstrated that long term remission of asthma might occur without the recovery of atopic disposition in the natural course of asthma and due to psychosomatic treatment. We made progress in the methodology for the investigation of psychosocial factors, and psychosomatic treatment of asthma, and published it in the book "Guideline for diagnosis and treatment of psychosomatic diseases" in 2002. 2) Occupational mental health promotion has become an urgent issue at work in the recent years. At present, we are engaged in the research and development of new stress management systems, improved method of active listening and the publishing of education programs and manuals for suicide prevention. It is thought that industrial medicine is one of the new fields for further development of PSM. 3) Although PSM have now faced with financial problems in the practice under the policy for suppression of medical expenses, I believe that establishment of a specialty system for authorized physicians including PSM and reward reflected this system may resolve this problem. 4) The demand and role of PSM is speculated to increase in the 21st century according to the increase of stress and stress-related diseases. We should make an effort to improve our therapeutic mind and technical skill for treating of PSD and also some mental dysfunction, and to research the mechanism of mind-body connection to keep the specialty as psychosomatist, for the further development of PSM.

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Previous studies showed that patients with depression lose their bone mineral densities due to the hyperactivation of HPA axis. Glucocorticoid (cortisol) is said to be the main factor which accelerates bone-resorption in depressive patients. In this paper, we studied POMS scores. which is said to reflect recent emotional states, in 59 young healthy women from 18 to 30 years old. And we compared them with plasma ACTH, cortisol, catecoalamines. B-ALP. IL-6 and TNF-α. Also the change of urine NTx, the marker of immediate boneresorption, was investigated. Cortisol group H showed significantly higher level of ACTH and significantly lower TNF-α compared with other lower cortisol groups. This indicates activation of HPA-axis tend to inhibit peripheral inflamatory cytokine activities. We found no differences in POMS scores among cortisol group H, M and L. In IL-6 group H, however, NTx, TNF-α, and NTx/B-ALp were found to increase significantly compared with IL-6 group L. And also IL-6 group H showed significantly higher POMS T-A score, which reflects recent degree of emotional tension and anxiety. There was no significant difference of POMS depressive score between these two groups. From these, we suspected that recent emotional stress which increase tension and anxieties should increase peripheral IL-6 and the degree of bone-resorption which is represented by NTx. In the case of severe depression, hyperactivation of HPA-axis facilitates bone resorption through the activation of adrenal-cortisol system. However, short term stress which evokes stress-coping tension and anxiety, should accelerate bone resorption-process to keep cell-homeostasis through activating peripheral IL-6.

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The purpose of this study was to investigate the psychological characteristics, personality traits, selfesteem and sense of identity, of Japanese female college students with disturbed eating behaviors and to describe their disturbed eating behaviors. The subjects were 304 female college students in a Japanese suburb. Twenty-one female outpatients diagnosed with BN-P were recruited from psychosomatic and psychiatric clinlcs to compare with the students. They completed the EAT-26, the NEO-FFI, the Rosenberg Self-Esteem Scale, and the 3 subscales (Trust, Autonomy, Identity) of the EPSI, as well as cluestionnaires on purging behavior and binge eating. Students were divided into 3 groups according to thelr EAT-26 scores : nondisturbed, moderately disturbed and severely disturbed. We then compared NEO-FFI scores. Rosenberg Self-Esteem scores and EPSI scores between the three student groups and the outpatient group. Data were analyzed by using ANOVA and Bonferroni's multiple comparisons. Almost 3.5% of the students were categorized as belonging to the moderately or severely disturbed groups. Binge eating, at a frequency of 2-3 times a week or more, was reported by 8.9% of the students. Regarding purging behaviors, 15.8% of the students reported. These findings indicate that the prevalence of disturbed eating behaviors in Japanese female college students is a serious problem, indicating the immediate need for preventive intervention. Regarding personality traits, the moderately and severely disturbed groups scored significantly higher for "Neuroticism" than the nondisturbed group (p<0.05, p<0.001, respectively). The 3 student groups scored significantly higher for "Extraverslon" "Agreeableness" than the outpatiellt group (p<0.001). The moderately and severely disturbed group had scores for "SelfEsteem" that were significantly lower than those of the nondisturbed group (p< 0.001 p<0.01, respectively). The severely disturbed group scored significantly lower for "Trust", "Autonomy" than did the nondisturbed group (p<0.01, p<0.05, respectively). The moderately and severely disturbed group had scores for "Identity" that were significantly lower than those of the nondisturbed group (p<0.05, p<0.001, respectively) . Our results also suggest that students with disturbed eating behaviors are characterized by high "Neuroticism" and low "Self- Esteem" as well as a low sense of Identity in comparison with nondisturbed students, and by high "Extraverslon" and "Agreeableness" compared with the outpatient group. These psychological characteristics must be taken into consideration when planning college-based preventive intervention.

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