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Article type: Index
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Article type: Appendix
2006 Volume 46 Issue 1 Pages
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Jinichi Suzuki
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2006 Volume 46 Issue 1 Pages
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Setsuko Shibuya, Iwao Saitou, Hiromitsu Kikuchi, Kazuo Takaoka
Article type: Article
2006 Volume 46 Issue 1 Pages
55-65
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We have conducted, since 1991, counseling and Simonton Image Therapy in addition to biofeedback in terminal disease patients who felt despair and helplessness after being told that they have cancer and informed of their remaining lifespan. In a survey of 36 patients who had undergone image therapy, results regarding the effectiveness were as follows : 23 persons (63.9%) said they were more relaxed mentally and physically; 17 persons (47.2%) reported their symptoms lessened; 16 persons (44.4%) reported having hope for living; with regards to feelings toward therapy, 18 persons (50%) said they were willing to continue, looking forward to favorable results while 18 persons (50%) were willing to continue with a positive attitude. Psychological tests showed that of 17 persons, 13 (76.5%) suffered from depression, however, after image therapy, 11 persons (84.6%) reported an improvement in their condition. From these results, it can be said that image therapy is effective in the care of terminal cancer patients. In addition, we also report on the effective use of these therapies in the case of a terminal cancer patient who entered remission from his bone marrow cancer.
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Article type: Article
2006 Volume 46 Issue 1 Pages
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Kenjiro Okabe, Takehiro Inoo
Article type: Article
2006 Volume 46 Issue 1 Pages
67-73
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Objective : Patients with anorexia nervosa (AN) often show an absence of concern about emaciation, even when advanced, and defend against therapy to improve their emaciation. Therefore, these patients could be considered to have no recognition of their illness. Not only patients with AN but also patients with bulimia nervosa have body image distortion, which is recognized to be influenced not by perceptual disturbance but by affective, or nonsensory factors. We interviewed patients with eating disorders about their evaluation of their own body as well as their desire about their body in order to explore the issue of the anorexic's recognition of illness. Subjects and Method : Subjects consisted of 402 patients (10 males and 392 females) with various eating disorders, which including 92 patients with the restricting type of AN (AN-R), 46 patients with binge-eating/purging type of AN, 12 patients with purging type of AN, 39 patients with subclinical AN, 147 patients with purging type of bulimia nervosa, 28 patients with nonpurging type of bulimia nervosa, 4 patients with subclinical bulimia nervosa, and 34 patients with eating disorder not otherwise specified. The mean BMI of these patients was 16.7 (ranging from 8.4 to 32.4). We asked the following questions during the first contact with our clinic. (1) "Do you think you are too thin?" (2) "Do you want to lose more weight?" (3) "Do you hate to gain weight?" (4) "Do you think any parts of your body are too fat?" (5) "How much do you want to weigh?" Result : Among patients with a BMI less than 16, 86% thought that they were too thin, while 97% of patients with a BMI more than 18 did not consider themselves too thin. Of patients with a BMI more than 18, 80% wanted to lose more weight, while 90% of patients with a BMI less than 16 did not want to lose more weight. The same pattern was found among patients with AN-R only. Even among patients with a BMI less than 16, 67% hated to gain weight. The percentage of patients who answered that some parts of their body were too fat increased in proportion to BMI, although even some emaciated patients thought that some parts of their body were too fat. The mean self-stated ideal weight was correlated with BMI and actual weight minus self-stated ideal weight also correlated with BMI. Conclusion : This study suggests that most anorexics with a BMI less than 16 were aware of their emaciation and wanted to gain more weight, although they imposed a low ideal weight. However, they hated gaining weight despite being emaciated. The dissonance between fear of gaining weight and perception of emaciation might induce a lack of concern about emaciation.
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Akiko Haga, Chiharu Kubo
Article type: Article
2006 Volume 46 Issue 1 Pages
75-86
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Objective : The characteristics of disabilities and social adaptation of children with developmental disabilities were studied in relation to the anxiety and/or depression of their mothers. Subjects : The data of 45 mothers of children with developmental disabilities, evaluated in the outpatient facilities of the Department of Psychosomatic Medicine, Kyusyu University Hospital and affiliated hospitals, was evaluated. All received six months or more of pharmacological treatment or psychotherapy, including 23 mothers of children with attention deficit/hyperactivity disorders (ADHD group) and 22 mothers of children with pervasive developmental disorders (PDD group), as well as a control group of 23 mothers. Method : Evaluation with the SDS depression scale and the STAI anxiety scale was done at baseline and six month after therapeutic intervention. The social adaptation of the children was evaluated using the DSM-IV GAF scale. Results : The results indicated that the ADHD group had a significantly higher degree of anxiety and/or depression (p<0.01) than the PDD and the control group. There was no correlation between the social adaptation of the children and anxiety and/or depression in the mothers. Some mothers in the ADHD group had a high degree of anxiety and/or depression that persisted after therapeutic intervention, including some who experienced divorce, abuse, domestic violence, or maternal psychopathology. Our data demonstrate that the background of the anxiety and/or depression in mothers originate not only from their children with developmental disabilities but also the existence of serious psychosocial background and maternal psychopathology. Conclusion : These results suggest that the specific psychotherapy intervention is needed for the prevention of secondary comorbid condition in mothers.
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Kyoko Nishikori, Hiroshi Sogawa, Chiharu Kubo
Article type: Article
2006 Volume 46 Issue 1 Pages
87-93
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Obstetricians and gynecologists participate in women's life at their various turning points in a woman's life through their relationship with the delicate topic of "sex." Therefore, many patient complaints that obstetricians and gynecologists encounter every day require not only somatic diagnosis and medical treatment, but also must be approached from the aspect of psychosomatic medicine. However, few medical case reports about psychosomatic medicine in the obstetrics-and-gynecology domain are to be found in Japan. In this paper, we report three obstetrics-and-gynecology cases involving psychosomatic problems in which the mind/body approach was very effective. These patients consulted our obstetrics-and-gynecology clinic with such complaints as "anovulatory disorder associated with polycystic ovary", "anxiety at the time of menopause", and "GnRHanalogue side effects". In addition to obstetrics-and-gynecology evaluation and medical treatment, improvement was seen through the use of psychotherapies such as counseling and Dohsa-hou and the prescription of anti-anxiolitics and anti-depressants.
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Article type: Appendix
2006 Volume 46 Issue 1 Pages
95-98
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