The Japanese Society of Psychosomatic Medicine (JSPM) was founded in 1959, followed by the 1st Congress the next year. Now we hold the 46th Congress this year, with a membership of about 3700 people. Briefly speaking of the history of JSPM, the guideline of therapy for psychosomatic disorders was issued in 1970. JSPM became affiliated with the Japanese Association of Medical Sciences in 1979, and started the authorized educational and training system of psychosomatic medicine for doctors as specialists in 1985. The revised guideline on diagnosis and treatment of psychosomatic medicine was issued in 1991. Moreover, the term "Shinryo-naika" which means psychotherapeutic medicine in Japanese was officially approved for use in 1996. JSPM also introduced the authorized educational and training system for medical psychologists in 2005. I will talk about the episodes and the memories of activities performed by the pioneers of psychosomatic medicine in Japan, especially with a focus on the old days. Reviewing the developing history and progress of psychosomatic medicine in Japan, I will also make some remarks on psychosomatic medicine.

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Object: A cross-sectional survey was carried out with a purpose of examining insomnia, QOL, depression, and anxiety between day workers and shift workers. Subjects and methods: A self-administered questionnaire for Pittsburgh Sleep Quality Index (PSQI), WHOQOL26, SRQD and STAI were distributed to 571 male workers (307 day workers and 264 shift workers) at an anonymous company in Japan. Results: (1) PSQI: The total score of shift workers was significantly higher than that of day workers. Night workers had the highest prevalence of insomnia among the three shifts. (2) WHO QOL 26: Mean social scores of WHO QOL 26 of shift workers were significantly higher than that of day workers. (3) SRQ-D: Mean scores of SRQ-D of day workers were significantly higher than that of shift workers. (4) STAI: Mean scores of state anxiety and trait anxiety of day workers were significantly higher than that of shift workers. Conclusion: The prevalence of insomnia in shift workers was higher than that in day workers. Night workers had the highest prevalence of insomnia among the three shifts. There were no differences between the two groups in depression. As to QOL, the social factor for day workers were significantly higher, and as to depression and as to anxiety, state anxiety and trait anxiety were higher compared with other shift workers.

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Purpose: There are many different types of scales for measuring stress responses. However, most of available scales have certain problems. Some need considerable time and effort to administer, whereas others measure only psychological aspects of stress. The Public Health Research Foundation Stress Check List Short Form[PHRF-SCL (SF)]was developed to fulfill the need for a more practical scale. Its reliability and validity were examined in this study. Method: The original PHRF-SCL is a self-report scale that consists of 50 items measuring stress responses of young people and adults. Participants were 24,854 males and 9,702 females that responded to the PHRF-SCL. Factor analysis with Promax Rotation was conducted for item selection. Reliability of the test was examined using the Cronbach's α. Construct validity was examined using the following 3 analyses: a) confirmatory factor analysis, b) comparison among groups that were expected to show different stress responses, c) correlation analysis of PHRF-SCL (SF) scores and stressor scores. Criterion related validity (concurrent validity) was examined by conducting correlation analysis between PHRF-SCL (SF) scores and Cornell Medical Index (CMI) scores. Results: Twenty-four items of the PHRF-SCL (SF) were eliminated as a result of factor analysis. It was shown that PHRF-SCL (SF) has 4 factor structure: anxiety/uncertainty (6 items), tiredness/physical (body) responses (6 items), autonomic symptoms (6 items), and depression/feeling of insufficiency (6 items). PHRF-SCL (SF) had a high reliability coefficient (0.71-0.85). Also, PHRF-SCL (SF) scores and stressor scores were significantly correlated. Confirmatory factor analysis indicated high fitness between data and models. An ANOVA and a t-test indicated that a group of participants who had experienced a change of jobs had significantly higher scores on this scale than a control group without such an experience. Also, a group of participants with a stress control strategy had significantly lower scores on the scale than a control group without such a strategy. Moreover, CMI scores were significantly correlated with PHRF-SCL (SF) scores. Conclusion: The results of this study suggest that PHRF-SCL (SF) is a useful scale with high reliability and validity.

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Objectives: We investigated developmental disorders noticed only after the onset of psychosomatic disorders or maladaptive behaviors, by compairing them with cases in which such symptoms occurred after developmental disorders were diagnosed. Subjects: The study population comprised 70 pediatric patients with developmental disorder selected from among 691 children who visited the outpatient psychosomatic clinic of the Department of Pediatrics, between January 1993 and April 2002. Method: The subjects were divided into two groups: those with an established diagnosis of developmental disorder already made at the first visit, and those diagnosed as having the disorder only after the first visit. They were characterized by the type of disorder. Results: In the group with the diagnosis made only after the first visit, Asperger's disorder, pervasive developmental disorder not otherwise specified, and attention deficit/hyperactivity disorder were prevalent, showing higher incidences of reactive physical symptoms compared to the group with the previously established diagnosis. Additionally, because underlying developmental disorders had not been noticed, a vicious circle was evident in which the lack of appropriate management led to aggravation of symptoms. Conclusion: In the management of child with chief complaints of psychosomatic disorders or maladaptive behavior, it is important to bear in mind the possibility of developmental disorders.

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Objectives: The purposes of this study were to clarify the effects of distraction on a decrease of pain intensity in experimental and clinical settings, and to examine the influences of pain intensity and strength of anxiety on the effect of distraction on a decrease of pain intensity. Methods: Studies were identified from electronic searches and were included if these studies met the following criteria: (1) RCT were conducted in the acute pain setting; (2) participants were adults; (3) the effects of pain reduction were examined; (4) statistical indicators for meta-analysis were described. Results: The results indicated that while distraction had a moderate effect on both experimental pain (d=0.65) and clinical pain (d=0.50), the effect size was greater on experimental pain than on clinical pain. The correlation between strength of anxiety and the effect size of distraction was significant (r_s=-0.68), while the correlation between pain intensity and the effect size of distraction was not significant (r_s=-0.17). Conclusion: This study revealed that distraction was an effective strategy to decrease the intensity of experimental and clinical pains, and these effects were influenced by the extent of anxiety.

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