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Article type: Cover
2010 Volume 50 Issue 3 Pages
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2010 Volume 50 Issue 3 Pages
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Article type: Index
2010 Volume 50 Issue 3 Pages
181-
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Article type: Index
2010 Volume 50 Issue 3 Pages
181-
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
182-183
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2010 Volume 50 Issue 3 Pages
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
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Tomoyasu Ichijo
Article type: Article
2010 Volume 50 Issue 3 Pages
185-
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Article type: Article
2010 Volume 50 Issue 3 Pages
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Michitaka Nagura
Article type: Article
2010 Volume 50 Issue 3 Pages
187-194
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Age-related changes of life functions, in addition to types and severity of illness, adversely affect the psychosomatic health of elderly individuals. The changes are irreversible, even when advanced therapeutic techniques are applied. However, seniors can maintain a healthier condition by practicing wellness-constantly evaluating their own health and fine-tuning the mind and body, as well as the environment, to improve the quality of life. The present paper will first outline practical and concrete methods of wellness for senior citizens. As the International Classifications of Functioning, Disability and Health (ICF) endorsed by the World Health Organization in 2001 indicate, an interrelationship among psychosomatic functions, daily activities, and social participation affects favorable life-functioning capacity. The idea, which implies that both environmental and individual factors influence our general health, could help medical personnel to create therapeutic modalities for keeping age-related alterations in life functions of the elderly as healthy as possible. From my clinical experience obtained in Geriatric Counseling at the Department of Geriatrics, Kyoto University Hospital, I have found counseling, rather than medical supervision, offers a more favorable way for the elderly to modify voluntarily their lifestyles. This paper further discusses the efficacy and practical applicability of specialized medical counseling for senior citizens.
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Masanori Handa
Article type: Article
2010 Volume 50 Issue 3 Pages
195-200
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Today in hyper-aging society in Japan, the problems of care and treatment for fragile old people are serious. It is one of big social problems that family caregivers often become depressive and abuse old care-recipients under stress. Psychosomatic care and treatment for the aged become increasingly quite important. We interviewed 35 key family caregivers to the elderly in Asakura area, a central part of Fukuoka, Japan to examine chiefly caregivers' burden and depressive symptoms. The result is that many key caregivers are depressive and exhausted both in mind and body. This shows social and mental support to the family including caregivers is greatly needed in the care for the aged.
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
200-
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Katsumi Iijima
Article type: Article
2010 Volume 50 Issue 3 Pages
201-208
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The characteristics of the practice by primary care physicians in the community are accessibility, continuity, comprehensiveness, coordination, and accountability. So it is proper for them to see the elderly patients who have both somatic and psychosocial problems. My clinic is located at the urban area, and gives primary care services to the community people. Since May 1999 through Spring 2004, 4,476 patients visited my clinic. Among them, 322 patients (7.2%) were treated at the psychosomatic division. The number of patients over 65 years-old who visited that division was 64 (19.9%). Their three most frequent diagnoses were mood disorder, adjustment disorder, and anxiety disorder, which consisted 65.5% of these 64 patients. Three most frequent stressors which triggered the onset of the disorders were death of the partner, domestic conflicts and somatic impairments. Useful psychosomatic skills for primary care physicians, I think, are as follows. Medical interview skills which is based by Narrative based medicine, Biopsychosocial model, Family-oriented techniques, Cognitive therapy, Behavioral therapy and Psychotropic medication.
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Masatoshi Hayashi, Yoshinobu Hamada
Article type: Article
2010 Volume 50 Issue 3 Pages
209-216
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Many middle-aged to elderly women may develop essential hypertension, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, or urinary disturbance. Although each disease causes characteristic complaints, women in this age group often express a variety of other indefinite complaints. These underlying complaints along with indefinite complaints cause a remarkable deterioration of their QOL. It is not sufficient to treat only the underlying disease. The other abnormalities that cause various indefinite complaints require appropriate management. Some doctors usually diagnose a female patient's illness clinically based on her chief complaints. However, other doctors may diagnose such illness based not only on her chief complaints but also on her indefinite complaints. In the treatment of middle-aged to elderly women, the latter group of doctors may have an advantage in improving the patient's condition because these older patients have a greater number of indefinite complaints than younger patients. In other words, the former group of doctors "treats the illness" and the latter group "treats the patient." "Treating the patient" can improve the patient's QOL, which is essential to maintaining health. Questionnaires are very effective in eliciting the patient's abnormalities and facilitate the administration of medicine to patients. These questionnaires consist of simplified menopausal index (SMI) and Kupperman index to diagnose a menopausal disorder, SDS (Self-rating Depression Scale), SRQ-D (Self-Rating Questionnaire For Depression), and HDRS (Hamilton Depression Rating Scale) to diagnose depression, and OABSS (Overactive Bladder Symptom Score) to diagnose overactive bladder (a urinary disorder). We propose that "treating the patient" is very important and beneficial for middle-aged to elderly women after a medical examination by interview and filling out a questionnaire.
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Gen-yuki Yamane
Article type: Article
2010 Volume 50 Issue 3 Pages
217-224
Published: March 01, 2010
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Until the 1970's in Japan, there were many patients who required dental prostheses for caries, periodontitis and missing teeth. In 1989, the 8020 campaign was promoted by dental associations and the Ministry of Health, Labor and Welfare of Japan. Initially, 80-year-olds had about 4 teeth, but in 2006, about 20% of 80-year-olds had 20 teeth. When many elderly had no teeth, the main job of dentists was to recover masticatory function by making dentures, but today, comprehensive dental care including treatment of periodontal disease and tooth extraction are required in elderly patients with systemic risk factors. In addition, the pain of the tongue, dry mouth and other oral diseases occur to the old man frequently. When the pain of the tongue and mouth dryness last long, an oral functional disorder becomes severe, and the whole body symptom is being expressed, too. The symptom of psychosomatic dentistry causes oral functional disorders and declines the quality of the life in elderly. The old man who can take an active life attitude has a few dentistry psychosomatic diseases. Dentistry contributes like this in the health of mind and body greatly to the old man.
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[in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
225-
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Fumiyuki Goto, Kimiko Nakai, Kaoru Ogawa
Article type: Article
2010 Volume 50 Issue 3 Pages
229-236
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Objective: Psychosomatic disorders are defined as somatic disorders with organic or functional abnormality, in which the clinical course was greatly affected by psychosocial factors. The common symptoms observed in otolaryngology include globus syndrome, dizziness, tinnitus, and so on. Psychosomatic medicine for the treatment of these disorders is not prevalent in otolaryngology. The objective of this study is to investigate the prevalence of psychosomatic and psychiatric disorders in the department of otolaryngology at general hospital. Methods: Subjects were 586 patients who consulted the author in the department of otolaryngology from March 2006 through June 2006. Records in their medical charts were retrospectively reviewed. Results: Of them, 133 (22.7%) were considered to have a psychosomatic disorder. The rate of psychosomatic disorders was high in globus syndrome, dizziness, tinnitus, and chronic pharyngitis as 52.9%, 46.4%, 42.9%, 37.5%, respectively. The treatment was based on the explanation of mind-body relationship. Counseling and autogenic training by a clinical psychologist were introduced in 8 patients who were unresponsive to the medical explanation. Conclusion: It is not rare to see patients with psychosomatic disorders in the field of otolaryngology. In this study it is confirmed that there are a certain number of patients with psychosomatic disorders in the field of otolaryngology. It is important for otolaryngologists to examine their patients as psychosomatic otolaryngologists with an understanding of psychosomatic medicine to diagnose psychosomatic disorders.
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Hirotaka Tanikawa
Article type: Article
2010 Volume 50 Issue 3 Pages
237-244
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
245-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2010 Volume 50 Issue 3 Pages
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
246-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2010 Volume 50 Issue 3 Pages
246-
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
246-247
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
Article type: Article
2010 Volume 50 Issue 3 Pages
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[in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
247-
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
247-248
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Article type: Article
2010 Volume 50 Issue 3 Pages
248-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
248-249
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
249-
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[in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
249-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
249-250
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
250-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
250-
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[in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
250-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
250-251
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Article type: Article
2010 Volume 50 Issue 3 Pages
251-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
251-
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]
Article type: Article
2010 Volume 50 Issue 3 Pages
251-
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[in Japanese]
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2010 Volume 50 Issue 3 Pages
252-
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
253-255
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2010 Volume 50 Issue 3 Pages
256-
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
257-
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
258-260
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
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Article type: Appendix
2010 Volume 50 Issue 3 Pages
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2010 Volume 50 Issue 3 Pages
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Article type: Cover
2010 Volume 50 Issue 3 Pages
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