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Article type: Cover
2010 Volume 50 Issue 10 Pages
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Published: October 01, 2010
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2010 Volume 50 Issue 10 Pages
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Article type: Index
2010 Volume 50 Issue 10 Pages
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Article type: Index
2010 Volume 50 Issue 10 Pages
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 10 Pages
894-
Published: October 01, 2010
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 10 Pages
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 10 Pages
895-
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Takehiro Nozaki
Article type: Article
2010 Volume 50 Issue 10 Pages
895-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
896-898
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2010 Volume 50 Issue 10 Pages
898-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
899-901
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
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Mahito Kimura
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2010 Volume 50 Issue 10 Pages
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
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Sumiko Okura
Article type: Article
2010 Volume 50 Issue 10 Pages
905-912
Published: October 01, 2010
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In 2004, the Japanese Society of Psychosomatic Medicine established an authorization system for medical psychologists, in anticipation of their playing an important role in a wide range of medical departments practicing holistic medicine, which include the areas of psychosomatic and psychiatric medicine. In our hospital, medical psychologists are a part of medical care team when providing diabetes inpatients with treatment and education, and are responsible for conducting lectures on diabetes and psychological assessments, which include interviews and tests (PAID, scale of dietary distress, SDS, and Baumtest). We provide "diabetes acceptance assessment sheets" to allow doctors, nurses, nutritionists, pharmacists and medical psychologists to fill in the phases of each patient's acceptance regarding the disease and treatment. These are also used to discuss problems in conference, including those related to the patient's psychosocial environment and subsequent stages of treatment. The main roles of medical psychologists in medical care team are to share psychological assessments with other team members and act as an intermediary between patients and other staff. This makes their role essential in clinical diabetology.
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 10 Pages
913-
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Shin Fukudo
Article type: Article
2010 Volume 50 Issue 10 Pages
915-919
Published: October 01, 2010
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Research on irritable bowel syndrome (IBS) provides basic and clinical keys to solve the psychosomatic problems in gastrointestinal (GI) diseases. Major pathophysiologic features of IBS are stress-induced dysmotility of the GI tract, visceral hypersensitivity, and emotional dysregulation mainly manifested by anxiety and depression. One of etiologies of IBS has been focused on post-infectious IBS, which is IBS developed after the acute gastroenteritis of bacterial or viral origin. Fundamental mechanisms of IBS are thus focused on interactions between immune system and nervous system in the GI tract. Research on brain-gut interactions using positron emission tomography, functional magnetic resonance imaging, and viscerosensory evoked potentials has been clarifying mechanism of visceral perception and perception-related emotion. Furthermore, research on IBS will be useful to understand the functional module and neurotransmitters of the brain regulating emotional regulation and changes in GI functions under stress.
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 10 Pages
922-
Published: October 01, 2010
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Masanori Handa
Article type: Article
2010 Volume 50 Issue 10 Pages
923-930
Published: October 01, 2010
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Main symptoms of functional esophageal disorders are heartburn, chest pain, dysphagia. They consist of mainly esophageal motility disorders, gastroesophageal reflux disease (GERD), non-cardiac chest pain (NCCP), but they are often overlapped each other. The first diagnosis needs to exclude gastrointestinal structural disorders, metabolic disorders and ischemic heart diseases. Additionally, a functional diagnosis is defined by esophageal X ray (Barium swallow), esophageal manometry, 24-hr ambulatory esophageal pH monitoring, and provocative tests. The Rome III classification system in functional esophageal disorders doesn't work well in clinical practice. It is not only clinically but psychosomatically useful to use 'dyspepsia' as the generalized symptoms-term of the upper functional gastrointestinal disorders (FGID) including the esophageal disorders. In treating FGID patients, management is largely empirical and we should consider their psychosocial factors, behaviors and "the meaning" of their symptoms.
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Hiroshi Kaneko
Article type: Article
2010 Volume 50 Issue 10 Pages
931-938
Published: October 01, 2010
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Symptoms of functional dyspepsia have been focused on 4 symptoms, and 2 categories have been proposed in relation to meals ('postprandial distress syndrome' and 'epigastric pain syndrome') (Rome III). The goal of this proposal is to clarify respectively specific pathology and to establish a logical treatment approach. It is speculated that insufficient adaptive relaxation (accommodation) of the proximal stomach, which is active relaxation reflex during and after the ingestion of a meal, may be accompanied by a rapid gastric emptying-induced duodenal stimulation followed by the delay of gastric emptying as a result, inducing postprandial distress syndrome. Explanation and assurance result in treatment effect in patients with anxious status. Usefulness of prokinetics and acid suppressive agents to functional dyspepsia has been verified, and good patient-doctor relationship-based on psychosomatic approach should be necessary to improve the quality of life as a treatment goal.
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Motoyori Kanazawa
Article type: Article
2010 Volume 50 Issue 10 Pages
939-947
Published: October 01, 2010
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Considering the strategy for management of irritable bowel syndrome (IBS), it is important for physicians to make a positive diagnosis as IBS. Adequate interview with patients should be needed to establish an effective doctor-patient relationship and to make a treatment plan. In addition to education and life style modification as a basic management, pharmacotherapy and/or psychotherapy should be applied according to the dominant symptom(s) and severity. Such psychosomatic approach based on a bio-psycho-social model plays a major role for treatment of moderate to severe patients. There are no specific biomarkers for IBS at this point. To set a realistic goal and to help the patient take responsibility may lead a better outcome.
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Hiroaki Kusunoki, Naoto Yamashita, Keisuke Honda, Kazuhiko Inoue, Mana ...
Article type: Article
2010 Volume 50 Issue 10 Pages
949-954
Published: October 01, 2010
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Inflammatory bowel disease (IBD) has been thought to be a relatively intractable disease. This disease has a populational peak at the juvenile generation and some patients must undergo surgical treatment. In the present report, we reviewed the relationship between IBD and psychosocial factors of the patients with IBD such as their personality and psychosomatic aspects. The frequent contribution of psychosocial factors at the onset and exacerbation is seen in IBD patients, and dietary and pharmacological factors also contribute frequently to the course of the IBD. Therefore, clinicians must not only recognize the importance of the patient's physical conditions but also be aware of psychosomatic aspects of patient the treatment.
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Yuko Ishizaki
Article type: Article
2010 Volume 50 Issue 10 Pages
955-959
Published: October 01, 2010
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The features of psychosomatic aspects of gastrointestinal disorders in child and adolescent are summarized as following two points: 1) there is a disease in which symptoms and condition in child and adolescent are different from those of adults with the same diagnosis; 2) There are some conditions which are seen only or mainly in child and adolescent. Irritable bowel syndrome and the gastro-esophageal reflex disease are regarded as problems having the former features. On the other hands, cyclic vomiting, and abdominal migraine are considered to diseases having the latter features. Because psychosomatic symptoms change by the age groups, it is important to understand physiological and psychosocial development according to the age of child and adolescent.
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Tomoyuki Watanabe, Saori Satoh, Toshiaki Yamamoto, Hisashi Kumashiro
Article type: Article
2010 Volume 50 Issue 10 Pages
961-968
Published: October 01, 2010
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Children with high-functioning pervasive developmental disorder show little tendency to be noticed of their problems. However, they often have difficulties with adaptations to school environment because they are not good at interpersonal relationship, and lack adequate social skills. This is a case report of a junior high school student who exhibited signs of school non-attendance since his early age. Improvements were seen when the case was intervened on the basis of the developmental disorder. For the improvement of interpersonal relationship, interventions that urged empathy based on communication supports, rather than the supports that forced self-insight, was given. Moreover, problem solving skills based on cognitive behavioral therapy and individualized inter-personal skills were performed. His mother was given insight into the relation between the basic developmental characteristics and the student's behaviors. As a result, the student became able to again attend junior high school, and go up to senior high school. It seems important to consider maladaptive states from the viewpoint of developmental disorder, and to perform detailed assessment of the behaviors. It also seems essential to intervene with enough consideration of the characteristics of the specific developmental disorder.
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Ayako Kawazoe, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2010 Volume 50 Issue 10 Pages
969-972
Published: October 01, 2010
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Fuminobu Ishikura
Article type: Article
2010 Volume 50 Issue 10 Pages
973-977
Published: October 01, 2010
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
978-986
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
987-989
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
991-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
992-994
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
995-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
996-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
998-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
998-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
998-
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Article type: Appendix
2010 Volume 50 Issue 10 Pages
998-
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Article type: Cover
2010 Volume 50 Issue 10 Pages
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