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2009 Volume 49 Issue 11 Pages
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Article type: Cover
2009 Volume 49 Issue 11 Pages
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Article type: Index
2009 Volume 49 Issue 11 Pages
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Article type: Index
2009 Volume 49 Issue 11 Pages
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Article type: Appendix
2009 Volume 49 Issue 11 Pages
1148-1149
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Article type: Appendix
2009 Volume 49 Issue 11 Pages
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Article type: Appendix
2009 Volume 49 Issue 11 Pages
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Article type: Appendix
2009 Volume 49 Issue 11 Pages
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[in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
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[in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
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Takahisa Ushiroyama, Ko Sakuma, Naoya Kosaka, Hideo Tsutsumi, Shoko Fu ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1157-1162
Published: November 01, 2009
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In modern medicine, the psychosomatic approach should contribute to cure many kinds of women's disease and promote women's health. In view of gender specific medicine, psychosomatic clinical skills which take mind-body correlation into consideration help to treat several women's disease such as premenstrual syndrome and climacteric disorder with undefined symptoms. Expected outcomes of treatment in the psychosomatic clinical approach for several women's diseases should include the improvement of quality of life. An important performance of physicians in the psychosomatic clinical approach requires the knack of being patient in treatment by giving continuous positive strokes which could make women comfortable in both mind and body.
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Yoko Sagara
Article type: Article
2009 Volume 49 Issue 11 Pages
1163-1170
Published: November 01, 2009
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Dysmenorrhea and premenstrual syndrome are reviewed from the gynecological and psychosomatic point of view. Concerning dysmenorrhea, appropriate information about self-medication of menstrual pain is important and patients should be encouraged to become responsible for their own menstrual experience through the psychosomatic approach. In the patients whose pain is coming from organic diseases including endometriosis, fibroma, and any other conditions, the effects of these conditions on their lifecycle should be considered. If a sexual traumatic experience is present, a supportive approach with particular consideration is necessary. As for premenstrual syndrome, making correct diagnosis with prospective dairy rating is the first priority. Moreover, on the premise that this syndrome is a biopsychosocial condition, the treatment should include not only medical treatment but also intervention in psychological and behavioral problems.
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Takashi Kano
Article type: Article
2009 Volume 49 Issue 11 Pages
1171-1176
Published: November 01, 2009
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If females become pregnant when their physical and/or mental condition is poor, the course of pregnancy is likely to be abnormal, elevating the mother-child survival risk through abortion or pathologic delivery. To avoid this, females are equipped with a maternity-protective mechanism (an autonomically driven host defensive reaction) by which minus control of pregnancy is effected so that pregnancy will not develop during such pathologic conditions. Thus, psychosomatic disease is now an important factor determining female sterility. The present study was undertaken to analyze the relationship between female sterility and psychosomatic disease through analyzing sterility in relationship to autonomic imbalance and depression, based on the data on Kupperman index for climacteric symptoms and SRQ-D score collected from the cases managed at our hospital. The analysis revealed that autonomic imbalance and depression correlate with sterility due to ovarian dysfunction. This result suggests that management of psychosomatic disease is important when dealing with female sterility in the present age and that Kampo (traditional Chinese herbal) medicine will play a significant role in management of such cases.
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Etsuji Satohisa, Takao Sano, Madoka Takahashi, Yasuko Saito, Erika Ito ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1177-1182
Published: November 01, 2009
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It is important to examine menopausal women from different angles. I usually diagnose them from psychosomatic medicine, mental diagnostic (DSM-IV), gynecological diagnostic and oriental (Kampo) medicine. We examined 2,166 cases of menopausal women who we treated in our clinic from 1995 to 2008. They can be sorted into four groups from a psychosomatic view, (1) somatic type (S-type, 1,001 patients, 46.2%), (2) depressive type (D-type, 640 patients, 29.5%), (3) neurotic type (N-type, 286 patients, 13.2%), (4) psychosomatic type (P-type, 239 patients, 11.0%). When they have been diagnosed by DSM-IV, there have been 1397 cases of somatoform disorders, 596 cases of mood disorders, 54 cases of panic disorders, 39 cases of anxiety disorders, 20 cases of sleep disorders, 9 cases of schizophrenia, 9 cases of adjustment disorders, 5 cases of sexual disorders, 4 cases of personality disorders, 3 cases of pain disorders, and 2 cases of eating disorders and 2 cases of conversion disorders. So we noticed that there were so many kind of levels of psychopathology. So we had to treat them individually. We had counseling to many patients who were sorted into P-type mainly, but to a few patients who were sorted into D and S-types. Many N and D-type patients were treated with tranquilizers and also D-type patients were treated with antidepressants. 1247 cases (57.6%) were treated by kampo therapy. 849 cases (39.2%) were treated by HRT. Prognoses were concerned with relationships to their husbands. We also show you a case of a menopausal woman who had a problem with her husband sexually. You can understand that she was D-type basically, and was S-type from her hormone state. Also, she was N-type from psychological tests and interviews. This case proves that menopausal disorder is one of the most typical psychosomatic disorder.
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Atsushi Fukao, Takahisa Ushiroyama, Nobuo Kurokawa
Article type: Article
2009 Volume 49 Issue 11 Pages
1183-1189
Published: November 01, 2009
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The psychosomatic significance of gender was considered by reexamination on our study and a case report of patients with Graves'disease: typical female physical disease. In the study of 73 Graves'disease patients, masculine gender shown by Adult scale (ability of rational consideration) of egogram, and/or feminine gender shown by Free Child scale (ability of describing feeling) of egogram, are related to early remission of hyperthyroidism. Additionally, such relationships were comfirmed by in a case report. These findings suggest that integration of feminine gender (anima) and masculine gender (animus) in female patients with physical diseases leads to psychological growth and associates with improvement of the physical diseases.
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[in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
1192-
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Ryo Motoya, Hirofumi Matsuoka, Yuji Sakano, Rina Kobayashi, Fumio Mori ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1193-1200
Published: November 01, 2009
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Objectives: It is likely that tension-type headache becomes chronic. However, the mechanism of maintenance and aggravation of pain is still unclear. Recentry, with regard to chronic pain such as low back pain, the model for explaining its mechanism has been propounded. In the model, both escape/avoidance, which is the behavioral aspect of fear of pain, and pain catastrophizing evolve to pain-related disability and cause persisting pain (Cook et al., 2006). Therefore, in our study, we investigated whether or not the mechanism of chronic pain which has verified mainly chronic pain like low back pain could be applied to tension-type headache. Methods: The participants of this study were 72 patients who met the International Headache Society Diagnostic Criteria for tension-type headache (27 males, 45 females; mean age 51.35, SD=15.30). They were required to complete a set of questionnaires. The set included (1) Headache Characteristics (including headache frequency, duration, and intension), (2) Hospital Anxiety and Depression Scale (HAD): depression, (3) Pain Catastrophizing Scale (PCS), (4) Pain Anxiety Symptoms Scale-20 (PASS-20): escape/avoidance, and (5) Headache Impact Test-6 (HIT-6). We confirmed the fit of the model by using structural equation modeling (SEM). Results: As a result, we found that the hypothetical model had a good fit in tention-type headache patients. It was revealed that pain catastrophizing directly influenced daily disability (0.36) and escape/avoidance (0.68). Moreover, escape/avoidance, strengthened by the pain catastrophizing, also influenced daily disability (0.34). Conclusion: We determined that pain catastrophizing and escape/avoidance were the important variables to address when considered pain chronicity for tention-type headache. Therefore, both pain catastrophizing and escape/avoidance can be assessed and dealt with in psychosomatic treatment for patients of tention-type headache. Further studies are needed to clarify the effect of intervention on patients targeted pain catastrophizing and escape/avoidance.
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Nobuyuki Kobayashi, Fumihiko Hamakawa, Yuzo Matsuo, Masahiro Takako
Article type: Article
2009 Volume 49 Issue 11 Pages
1201-1207
Published: November 01, 2009
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Objectives: In this study, we examined whether clinical profiles and psychological tests can predict the act of self-injury during treatment. Subjects and Method: Subjects were 1665 patients (male 605, female 1060, age 36.4±18.6 years) who had consulted at our clinic between 2000 and 2005. All subjects completed GHQ at the first visit. We assessed the history of consultation at psychiatry or psychosomatic clinics, the suicide ideation, the history of self-injury behavior, the act of self-injury just before having the first session at our clinic and the act of self-injury during our treatment by checking on clinical records. Results: Twenty-three percent of all subjects had the history of treatment at other clinics, 24.7 percent had suicide ideation, 5.1 percent had a history of self-injury behavior, and 1.5 percent had that just before consulting at our clinic. The act of self-injury during treatment was seen in 4.3 percent of 1132 patients who received treatment in our clinic. Self-harmed individuals were younger, and had higher prevalence of the history of psychiatric or psychosomatic treatment, the suicide ideation, the history of self-injury behavior, and showed elevated value of severer depression subscale of GHQ compared with non-self-harmed ones. Patients with eating disorders and depression hurt themselves more often than those with other diagnosis. Multivariate analyses revealed that the age, the suicide ideation and the history of self-injury behavior were significant variables to predict the self-harmed behavior in treatment. However, the prediction of the self-harmed behavior on an individual level was difficult. Conclusion: It was suggested that the age, the suicide ideation and the history of self-injury behavior at the first medical examination were most useful predictors of the self-harmed behavior during treatment among parameters examined in the current study. But predictive power was insufficient.
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[in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
1208-
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Mamoru Muraoka
Article type: Article
2009 Volume 49 Issue 11 Pages
1209-1212
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[in Japanese], [in Japanese]
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2009 Volume 49 Issue 11 Pages
1213-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1213-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1214-
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[in Japanese], [in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
1214-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1214-1215
Published: November 01, 2009
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1215-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1215-1216
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
1216-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1216-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1216-1217
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
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[in Japanese], [in Japanese]
Article type: Article
2009 Volume 49 Issue 11 Pages
1217-1218
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1218-
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2009 Volume 49 Issue 11 Pages
1219-
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2009 Volume 49 Issue 11 Pages
1219-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1219-1220
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1220-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1220-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2009 Volume 49 Issue 11 Pages
1221-
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2009 Volume 49 Issue 11 Pages
1221-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1221-1222
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2009 Volume 49 Issue 11 Pages
1222-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1222-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1222-1223
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Article type: Article
2009 Volume 49 Issue 11 Pages
1223-
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Article type: Article
2009 Volume 49 Issue 11 Pages
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Article type: Article
2009 Volume 49 Issue 11 Pages
1224-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1224-
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Article type: Article
2009 Volume 49 Issue 11 Pages
1224-1225
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