The mind does not grow up without the body (feeling). Not from the psychological point of view, but through the author's clinical experience, the author introduces the diagram hypothesis that the development of mind must be based on the body (especially sense). In this era, the "mind" or "mind education" is emphasized too much. There is a regrettable lack of the view that the mind does not grow up without body movements and body feeling. In the infant stage of development, relations between mother and child raise the basis of "expression," "confidence/pride" and "cognition." They are the most important abilities (to form personal relationships) which are required for the social performance. The author warns that the material prosperity, compulsory education after the World War II and the feminism ideology (the word gender free is coined by the Japanese) ruin the development of those abilities. One mentions that all doctors except for pediatricians must recognize the importance of childhood, because "all adults have grown up through their childhood".

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After much investigation on psychosocial factors of temporomandibular disorders, a topic that has long been discussed, it was found that the psychosocial factors were related to masticatory muscular pain and cervical muscular pain, but were not related to internal derangement of temporomandibular joint. Also anxiety and neurosis were stronger when the time took for patient to seek for treatment (suffering period) was longer, and a significant positive correlation was found between the two. When the suffering period was long, the treatment period became long, and the frequency of sleep apnea and exacerbating sleep bruxism became high. A significant positive correlation was found between the two respectively. Furthermore, exacerbating sleep bruxism was accompanied by hyperactivity of sympathetic nerve, emotional stress, and sleep disorders, and showed a significant positive correlation with pain score by palpation. On the other hand it showed a significant negative correlation with frequency of REM stage sleep. From these results it could be thought that the psychosocial factors of temporomandibular disorders were related to muscular pain but were mostly overlaid on the body. However special attention must be paid on the suffering period and sleep disorders.

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This study was designed to investigate the therapeutic effects of estrogen replacement therapy (ERT), selective selotonin reuptake inhibitor (SSRI), and ERT+SSRI on depression in postmenopausal women (Ohkura T et al: J Jpn Menopause Soc 12: 34-41). DSM-IV criteria was used to establish the diagnosis of depression. Forty-five postmenopausal women with depression divided into 3 groups of 15 women each were studied. The first ERT, second SSRI and third ERT+SSRI groups received conjugated equine estrogen (CEE) 0.625mg/day, paroxetine 10-20mg/day, and CEE 0.625mg/day+SSRI 10-20mg/day for 12 weeks, respectively. Mood was assessed at baseline, and 2, 4, 8 and 12 weeks after treatment using Hamilton Rating Scale for Depression (HAM-D). The mean HAM-D score (±SE) was 16.4±1.6 in ERT group, 15.7±1.3 in SSRI group, and 15.1±1.3 in ERT+SSRI group. The mean HAM-D score in each group was decreased 2, 4, 8 and 12 weeks after the treatment. (p<0.05-0.001). In conclusion, ERT improved depressive symptoms in postmenopausal women with depression. ERT+SSRI therapy was more effective in improving depression than ERT alone at 8 and 12 weeks, and SSRI alone at 8 weeks. In addition to the above mentioned study, 2 cases with postmenopausal depression in which ERT was very effective were presented in this article. Furthermore, endocrinological changes with climacteric ovarian dysfunction and social and psychological factors of stress behind climacteric depression were discussed.

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Background & aims: Most of patients with irritable bowel syndrome (IBS) have IBS symptoms since their middle teenage. However, analysis in detail of adolescent IBS was generally lacking. The objective of this research was to now the features of adolescent IBS in Japan. Subjects & Methods: We randomly selected junior high school students in Miyagi Prefecture, Japan, according to population of the areas of educational committees. The response rate was 76.9%, 833 boys and 888 girls (age: 15 y.o.) participated in this study. They fulfilled self-reported questionnaires which included Rome-II Modular Questionnaire (RIIMQ), Self-reported IBS Questionnaire (SIBSQ) based on Rome-II criteria, Generalized Self-Efficacy Scale (GSES), SF-36v2 and other questions on their lives. Results: One hundred and six boys (12.7%) and 145 girls (16.3%) were diagnosed as IBS by Rome-II Modular Questionnaire. No IBS students consulted hospital because of IBS symptoms at present or in the past. Distribution of residential area showed no significant difference between IBS students and controls who have no abdominal symptoms (boys: n=214, girls: n=148). In IBS symptoms of modular questionnaires, IBS girls had significantly severer symptoms in hard stool (p<0.0005), strain (p<0.05) and abdominal distension (p<0.005) than IBS boys, and IBS boys who had significantly more frequent defecation (p<0.05). Also, IBS girls showed severer lumpy stool (p<0.05), abdominal distension (p<0.005), perceived stress (p<0.001) and exaggeration of symptoms under stress (p<0.05) in a preceding week than IBS boys. IBS students complained sleep disturbance more often than controls, especially of sleep-onset insomnia (p<0.001), frequent awakening (p<0.001), non-restorative sleep (p<0.005) and feeling sleep short (p<0.0001). There were no significant differences in types of sleep disturbances except average sleeping time and feeling sleep short between IBS boys and IBS girls. IBS students had more traumatic episodes and felt their lives more stressful than controls (p<0.0001, respectively). IBS girls had more traumatic episodes (p<0.05) and felt more stressful in their lives (p<0.05) than IBS boys. Half of their traumatic episodes were related with their school lives. IBS students had lower scores in GSES (p<0.0001) and every SF-36v2 subscales (p<0.0001, respectively) than control students. In SF-36, IBS girls had higher PF scores (p<0.05) and lower MH scores (p<0.05) than IBS boys. Conclusion: Prevalence and psychological features of adolescent IBS were similar to those of adult IBS, however they also have unique characteristics.

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Background: It has been suggested that highly palatable foods such as those containing fat and sugar and their access schedule could be an important factor to induce binge eating, a main symptoms of bulimia nervosa or binge eating disorder. In this study, using fat (vegetable shortening), we investigated effects of two types of feeding schedule (Intermittent access (IA) and Continuous access (CA)) and their combinations on eating behavior in rats. Method: Two groups of rats (Sprague-Dawley, male), which already habituated to fat, were subjected to IA (1h/day for 6 times) or CA (24h/day for the same periods as IA) to fat under free access to regular food. After 6 days of no fat access period (fat withdrawal period), 1h fat intake was measured and, subsequently, the each group of rats was subjected to alternate fat access schedule. After second fat withdrawal period, 1h fat intake was measured again. The 1h fat intakes after each schedule were compared. Results: The 1h fat intake during IA gradually increased relative to each basal 1h fat intake and binge-like overeating was established. The established overeating was still remained after the fat withdrawal period. On the other hand, daily 24h fat intake during CA did not increase and also 1h fat intake after the fat withdrawal period did not increase. In the case of group which had IA firstly, the IA-induced overeating was diminished by the experience of subsequent CA. In the case of group which had CA firstly, although 1h fat intake increased during IA period, the increased fat intake did not remain after the fat withdrawal period. In addition, fat intake experiences suppressed the intake of regular food during the fat withdrawal periods, especially after CA of the group which had IA first. Conclusion: Our results suggest that IA could be a factor to induce and maintain overeating of fat and CA could reverse and prevent the IA-induced overeating.

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A role of clinical psychologists in a team approach to medical care is important. We reported two cases who improved through a clinical psychologist's approach focusing on drug taking behavior as their main theme during psychotherapy. In both cases, in the first half step of whole treatment courses, the patients found out their own proactive coping together with therapists, and the clinical psychologist respected their proactive behavior. In the next half step, the clinical psychologist tried to focus on patients' drug therapy itself as their topics. Then, patients improved to be able to cope with taking medicine and to make a good doctor-patient relationship. Through our experience of these two case, we considered that clinical psychologists can increase the effect of non-drug factors to build a good doctor-patient relationship. It seems to be important for us to build cooperative relationship with patient and to respect his/her independence. Clinical psychologists can contribute to increase the effect of non-drug factors in drug therapy.

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