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2005 Volume 45 Issue 5 Pages
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Article type: Index
2005 Volume 45 Issue 5 Pages
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Article type: Index
2005 Volume 45 Issue 5 Pages
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
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Masahito Ide
Article type: Article
2005 Volume 45 Issue 5 Pages
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Yoichi Ueta, Fumihiko Sakamoto, Seiji Yamada
Article type: Article
2005 Volume 45 Issue 5 Pages
323-330
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G-protein coupled receptors (GPCRs) for unknown endogenous ligands are called as orphan receptors. Recently novel biologically active substances including peptides have been discovered as unknown ligands of orphan GPCRs. Some of them are neuropeptides that are expressed in the hypothalamic areas that are known to be important sites to integrate the autonomic, neuroendocrine and immune responses to the stress. In this review we focused on novel neuropeptides that are orexins, neuromedin U and galanin-like peptide as candidates of mediators of the stress responses via the hypothalamus.
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[in Japanese], [in Japanese]
Article type: Article
2005 Volume 45 Issue 5 Pages
331-
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Masato Takii, Takehiro Nozaki, Kayo Oshikiri, Hiromi Urabe, Keisuke Ka ...
Article type: Article
2005 Volume 45 Issue 5 Pages
333-340
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In the study and treatment of eating disorders, a wide variety of mechanisms, psychological bases, and treatment methods have been advocated and practiced. Other diseases for which therapists have such widely differing perspectives are unusual. The reasons for this are 1) the various kinds and degrees of psychological/physical pathology of eating disordered patients, 2) the considerable differences in the general characteristics of patients visiting various facilities, for instance primary care vs. specialized care facilities and psychiatry vs. psychosomatic medicine, and 3) differences between therapists in fundamental ways of thinking about eating disorders. Medical facilities should cooperate with each other in the treatment of eating disordered patients based on an objective evaluation of each patient and an appropriate choice of treatment. The Department of Psychosomatic Medicine, Kyushu University mainly treats severe anorexia nervosa (AN) patients who have a severe desire for thinness and severe body weight loss. Inpatient therapy has been done by "Cognitive behavioral therapy with behavioral restriction". The average duration of inpatient therapy from 1990 to 2002 was 153 days, and the average increase of BMI was 3.1 (7.7 kg) . Factors independently affecting BMI gain in inpatient therapy were the duration of inpatient therapy and BMI at admission. The longer the duration of inpatient therapy and the lower the BMI at admission, the more BMI gain. Moreover, the prognosis 3.5 years after discharge was excellent or good for 70% of our AN patients who underwent inpatient therapy from 1996 to 2000. Although our inpatient treatment has led to a good prognosis for these severe AN patients, the current economic situation has pressured us to shorten the duration of inpatient therapy making it impossible for the patients to have the time necessary for successful recovery. It would be desirable to coordinate the ideas of the various elements of the medical system dealing with AN patients so that we can develop a more unified system of treatment, a treatment system that meets the great variety of needs of our patients, and to make greater efforts to promote our needs to public officials overseeing medical issues to insure that our proposed programs are accepted.
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
340-
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Toshihiko Nagata, Nobuo Kiriike
Article type: Article
2005 Volume 45 Issue 5 Pages
341-349
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Eating disorder patients are treated mainly in the outpatient clinic of our department. Our outpatient treatment consists of motivational enhancement and cognitive behavioral therapy. Patients are transferred to internal medical or psychiatric hospitals for short-term inpatient treatment if the physical or psychiatric condition is critical and requires emergent interventions. The patient is admitted to our open unit, if she is well motivated although progress is insufficient. Inpatient treatment consists of loose behavioral therapy rather than strict behavior restriction. Contract of behavioral treatment is confirmed on the first day of admission. Details of treatment are decided through a team conference. And patients are transferred to the outpatient clinic as soon as possible to treat them in the context of their ordinary life. Outcomes of anorexia nervosa showed similar results between patients who received inpatient and only outpatient therapy in our medium-term follow-up study. Inpatient treatment seemed to have limited indication, although this result can not be simplified to indicate that inpatient treatment is useless.
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[in Japanese]
Article type: Article
2005 Volume 45 Issue 5 Pages
349-
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Kenji Suzuki, Aya Takeda, Katsuyuki Shirakura
Article type: Article
2005 Volume 45 Issue 5 Pages
351-358
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Objective : We previously showed that binge eating and purging were considered as addictive behaviors, and the eating disorders education program (EDEP) based on the addiction theory was useful for treating bulimia. This study was conducted to show the effectiveness of EDEP in patients with bulimia by outcomes of one year follow-up after inpatient EDEP treatment. Methods : The subjects were 49 Japanese female patients with eating disorders who were inpatients treated using EDEP from June 2001 to March 2003 at the Kurihama Alcoholism Center of the Japanese National Hospital Organization. A semi-structured interview concerning eating problems, psychiatric disorders, and other clinical characteristics was conducted at the time of admission by the authors. At the time of discharge, the subjects were assessed for changes of symptoms by the authors. A follow-up survey of the subjects concerning eating problems and social status was conducted one year after EDEP treatment by mail or by telephone. Results : Forty five of the 49 subjects (91.8%) were followed-up of 12.5 months after discharge. At the time of follow-up, 10 of the 45 subjects (22.2%) had no eating disorder symptoms, 4 (8.9%) had had symptom free periods for 3 months but had relapsed at the time of the survey, and 3 (6.7%) had died. Among the 35 living subjects who had eating disorder symptoms, 47.6% remained within the same subtype of eating disorders, and the rest had changed to another subtype at the time of follow-up. Mean BMI and mean GAF of the living subjects increased at the time of follow-up compared with those at discharges. Conclusion : A follow-up survey of one year after EDEP treatment showed that EDEP was effective in promoting slow recovery of patients with eating disorders.
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Kei Hirai, Maki Hirai, Seiko Maeno, Takashi Hosaka, Fumio Yamada
Article type: Article
2005 Volume 45 Issue 5 Pages
359-366
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The purpose of this study was to develop a psychological group support program for stress management of nurses. The participants belonged to a medical school hospital in Japan. 17 nurses in the head and neck ward participated in our intervention program. All nurses were women, their mean age was 30.2 years and their average working life was 9.5 years. One intervention group had 4 or 5 participants and 5 weekly sessions. One session was 90 minutes long. We planed the contents of our program based on the Trans-Theoretical Model (TTM). Since the theory claims that different intervention is needed for different stages of behavioural changes, we firstly assessed the participants' stage of readiness for stress management to reduce their job-related stress. Most of all participants were on active and maintenance stage. Therefore, we focused on maintaining and enhancing the nurses' self-efficacy for managing their own stress whilst caring for patients. The contents of the program were : emotional support, cognitive reframing, providing psychological knowledge, enhancing self-efficacy, and relaxation training. We compared scores of psychological measurements between pre-and post-intervention. Mood status, self-efficacy and active coping style were significantly improved after the intervention. These results implied that our intervention would be psychologically efficacious for changing nurses' stress management behavior. Also there was significant improvement of perception for inter-colleague relationship. We discussed the process of development, efficacy and feasibility of the intervention program.
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Yoshiro Maebayashi, Makoto Tsuda, Miho Igarashi, Masatoshi Kawase, Ken ...
Article type: Article
2005 Volume 45 Issue 5 Pages
367-373
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We report two cancer patients whose psychiatric symptoms were relieved by the intervention of a palliative care team (PCT) which is organized for palliative care in the general ward. Both cases showed psychiatric symptoms after they were given the information that they had already been in their terminal stage. The case I was a 55-year-old man who had been operated on for his the bladder cancer. He showed strong anxiety and excitement, and was diagnosed as adjustment disorder. The case 2 was a 62-year-old man who had been operated on for his gastric cancer. He could not understand that he was in his terminal stage, and continued to request a chemotherapy which would have no effect on his illness. It was thought that he used a denial as a psychological defense. Their psychiatric symptoms were improved by psychotherapy, the alleviation of pain and psychosocial support. Then they said that they desired to be with their family calmly for the rest of their life. The PCT can play an important role in assisting advanced cancer patients in the general ward in relieving their anxiety and improving their quality of life.
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
375-381
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Article type: Article
2005 Volume 45 Issue 5 Pages
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2005 Volume 45 Issue 5 Pages
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2005 Volume 45 Issue 5 Pages
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
386-388
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
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2005 Volume 45 Issue 5 Pages
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Article type: Bibliography
2005 Volume 45 Issue 5 Pages
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
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2005 Volume 45 Issue 5 Pages
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2005 Volume 45 Issue 5 Pages
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Article type: Appendix
2005 Volume 45 Issue 5 Pages
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Article type: Cover
2005 Volume 45 Issue 5 Pages
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