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2007 Volume 47 Issue 8 Pages
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2007 Volume 47 Issue 8 Pages
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Article type: Index
2007 Volume 47 Issue 8 Pages
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2007 Volume 47 Issue 8 Pages
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[in Japanese]
Article type: Article
2007 Volume 47 Issue 8 Pages
684-
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[in Japanese]
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2007 Volume 47 Issue 8 Pages
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[in Japanese]
Article type: Article
2007 Volume 47 Issue 8 Pages
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Yoshiya Moriguchi
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2007 Volume 47 Issue 8 Pages
685-686
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
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2007 Volume 47 Issue 8 Pages
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Syohachi Shimooka
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2007 Volume 47 Issue 8 Pages
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[in Japanese], [in Japanese]
Article type: Article
2007 Volume 47 Issue 8 Pages
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Shin Fukudo, Toyohiro Hamaguchi, Michiko Kano, Jun Tayama, Motoyori Ka ...
Article type: Article
2007 Volume 47 Issue 8 Pages
691-695
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Mind-body relationship may be clarified by investigation of normal and abnormal brain processing of interoception and emotion. In particular, research findings in pathophysiological mechanism of irritable bowel syndrome (IBS) would be useful for applying the methodology to psychosomatic disorders in general. We measured regional cerebral blood flow by positron emission tomography (PET) with injecting H215O saline under the stimulation of the colon. The gut was distended with barostat bag. By distention, the thalamus, anterior cingulate cortex, insula, and prefrontal cortex were activated. Abdominal pain and anxiety well correlated with activation of these structures. There are some differences in the patterns of brain activation between healthy subjects and patients with IBS. The findings of interoception and emotion in IBS is suggested to be generalized to the other disorders.
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2007 Volume 47 Issue 8 Pages
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2007 Volume 47 Issue 8 Pages
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Masami Nishikawa, Yojiro Sakai, Hiroaki Kumano, Yuji Sakano, Hisanobu ...
Article type: Article
2007 Volume 47 Issue 8 Pages
697-703
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Gorman et al. proposed a "fear network" hypothesis as the neuroanatomical mechanism of the panic disorder in the human brain. This "fear network" should be centered in the amygdala and involve its interaction with the hippocampus and medial prefrontal cortex. Projection from the amygdala to hypothalamic and brainstem sites should consecutively lead to a lot of observed signs of conditioned fear responses. We have been studying regional brain glucose metabolism in patients with panic disorder using PET with [18F] fluorodeoxyglucose (FDG). One purpose of this study is to clarify the mechanism of the panic disorder in the human brain and to verify this "fear network" hypothesis. Another purpose is to investigate the effect of the "cognitive-behavioral therapy" on the human brain. In this study, we performed to compare regional brain metabolic rate for glucose in subjects with pre-treatment panic disorder to those in normal controls, and also to investigate the changes produced after successful completion of cognitive-behavioral therapy. The pre-treatment subjects with panic disorder showed significantly higher levels of metabolic activity in the bilateral amygdala, hippocampus and some regions of brainstem and cerebellum as compared with control subjects. After successful cognitive-behavioral therapy, areas of increased regional brain glucose metabolism were shown in the bilateral medial prefrontal regions, whereas areas of decreased metabolism were in the right hippocampus, left cerebellum, pons and so on, but there were no significant change in the amygdala. These results provided the first neuroimaging support in human patients for the "fear network" hypothesis of panic disorder. The results after cognitive-behavioral therapy, also, clearly explained the therapeutic mechanism in the human brain on the basis of this hypothesis.
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[in Japanese]
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2007 Volume 47 Issue 8 Pages
704-
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Yasumasa Okamoto, Akiko Kinoshita, Shinpei Yoshimura, Keiichi Onoda, M ...
Article type: Article
2007 Volume 47 Issue 8 Pages
705-712
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In this article, we present our neuroimaging studies by functional Magnetic Resonance Imaging (fMRI) about the brain mechanism of cognition toward elucidation of pathophysiology in depression. The first and second data show the brain mechanism (Kurosaki et al. 2005 ; Ueda et al. 2003) related to dysfunctional beliefs and systematic cognitive errors identified by Beck (1967), and the third is that (Tanaka et al. 2004) related to differential activation hypothesis proposed by Teasdale (1988). Lastly, we also show the change of brain function before and after cognitive behavioral group therapy (CBGT). Depressed patients before the CBGT showed attenuated activation in the dorsolateral prefrontal cortex, parietal cortex, and striatum were activated during the task. After the CBGT, the brain activation in good responders was restored as same as that in healthy control. However, in poor responder, there was no change on brain activation between before and after CBGT.
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Kiyoto Kasai
Article type: Article
2007 Volume 47 Issue 8 Pages
713-719
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This review describes structural and functional neuroimaging studies of posttraumatic stress disorder (PTSD). First, a combined structural MRI, diffusion tensor imaging, and event-related potential study in victims of Tokyo sub- way sarin attack revealed left anterior cingulate cortex (ACC) volume reduction which was tightly coupled with P300 amplitude reduction, and aberrant anterior cingulum integrity in PTSD patients. In a monozygotic twin study of US combat veterans, we found a significant volume reduction in the hippocampus in both combat-exposed PTSD subjects and their co-twins compared with both combat-exposed non-PTSD subjects and their co-twins. These results suggest that cortical abnormalities in PTSD may be characterized by those in limbic regions and medial prefrontal cortex that regulate the limbic regions. These abnormalities may at least in part represent pre-existing vulnerability to PTSD. Characterizing gene-environment interaction in the formation of medial prefrontal and limbic abnormalities will be important to uncover brain mechanisms for stress vulnerability and anxiety and depression spectrum disorders. Neuroimaging will be also a powerful tool for clinical application such as diagnosis and objective monitoring of treatment response in stress related disorders.
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Yasuyuki Mizuno, [in Japanese], [in Japanese]
Article type: Article
2007 Volume 47 Issue 8 Pages
721-728
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Background : In discussing the treatment of psychosomatic diseases, it is necessary to mention not only the diagnoses but subjective perceptions of the disease. We investigated the relationship between subjective perceptions of the disease and the effects of treatment. Subject : Seventy-one outpatients who had been treated for 6 months at the department of psychosomatic medicine in a medium-sized municipal hospital. Method : Participants were brought under 2 chief categories, objective and subjective. Diagnoses formed the objective category and the subjective category included the trigger of onset (present or absent) and the details of it (endogenous or exogenous). The Minnesota Multiphasic Personality Inventory (MMPI) were assessed two times, before the treatment and 6 months later, and analyzed in each category. Results : Scales 1, 2, 3 and 7 in the first MMPI were medium-higher than other scales in whole patients, then scales 1, 2, 3, 7 and 0 significantly decreased by the 6th-month treatment. The numbers of the patients who showed 70 or higher T score decreased by the 6th-month treatment on scales 2 and 7. The trigger present group showed higher scores on scales L and K than the trigger absent group although there were no interaction effects. No group and interaction effects were found between other groups according to the categories of the diagnoses and the details of trigger. Conclusion : Patients with psychosomatic disease have a tendency to be worried about somatic disease, depres- sive, tense, anxious, paranoid, repressive and denying. These are considered to be secondary acquired characteristics as they can be improved by treatment. Patients who are repressive and attempt to show themselves to be good tend to be conscious of triggers of onset, while those who have poor coping skills and develop psychological problems tend to have no triggers nor awareness of them.
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Ronko Itamura
Article type: Article
2007 Volume 47 Issue 8 Pages
729-739
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Background : Homeopathy is patient-centered medicine that treats the "individual patient" rather than the disease. Using this system, the therapist tries to understand the "individual patient" holistically and choose a homeo- pathic medicine (remedy) whose pattern of action is similar to the patient's clinical pattern. Morita therapy focuses on the provocation of patient's natural healing, not the removal or control of the disease symptoms, nor on finding out the cause or analyzing the patients. Methods : Homeopathic medical procedure is similar to that in conventional practices. In addition patients are asked about their own physiological and psychological condition before deciding on a homeopathic medicine. In out- patient Morita therapy, at the first stage, dealing with the attitude to their symptoms, patients come to accept the symptoms as they are. In the middle period, dealing with their attitude to daily life, patients start to change some aspects. In the last stage, they deal with their attitude to theirs life and personality. This study presents two cases treated with a combination of homeopathy and Morita therapy who made significant progress. One is an adult atopic dermatitis patient and the other is a severe depression patient. Conclusion : "Cure" means the elimination of all psychological and physical symptoms of patients that cause them distress. The concept of cure in the Morita therapy is based on the process of how to cope with life, which sug- gests that to live a full, productive, meaningful life anchors our lives in the reality of nature. This combination of therapies may induce a real cure in patients.
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2007 Volume 47 Issue 8 Pages
741-746
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
747-749
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
752-754
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
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Article type: Appendix
2007 Volume 47 Issue 8 Pages
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Article type: Cover
2007 Volume 47 Issue 8 Pages
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