The Asian College of Psychosomatic Medicine (ACPM) was established and made its debut as the Asian Chapter of the International College of Psychosomatic Medicine (ICPM-AC) with memorial lectures by five distinguished psychosomatists such as Professor Yujiro IKEMI (Japan), Amarendra Narayan SINGH (Canada), Burton G.BURTON-BRADLEY (Papua-NewGuinea) etc. and the officers were elected in Tokyo, on April 12, 1982. First President was Hitoshi ISHIKAWA (Japan), Vice Presidents were Mahalingam MAHADEVAN (Malaysia), Burton G.BURTON-BRADLEY (Papua-New Guinea), and General Secretary was Sueharu TSUTSUI (Japan). Five years before this, the preparation of associating the Asian Chapter of ICPM was started by delegates of participants from Asian countries at the 4^<th> World Congress of the ICPM held in Kyoto, Japan, September 5-9, 1977. The First Congress of the Asian Chapter of ICPM was held by President, Professor Yujiro IKEMI in Tokyo, May 19-20, 1984. Chief members in the beginning stage were Yujiro IKEMI, Hitoshi ISHIKAWA, Sueharu TSUTSUI, Taisaku KATSURA, Tetsuya NAKAGAWA, Hiroyuki SUEMATSU, Jinichi SUZUKI, Ziro KANEKO, Yuichiro GOTO, Shigeaki HINOHARA, Kazuo HASEGAWA etc., famous psychosomatists in Japan, and Hsien RIN (Taiwan), Seock Young KANG (Korea), Amarendra Narayan SINGH (Canada), Mahalingam MAHADEVAN (Malaysia), Burton BURTON-BRADLEY (Papua-New Guinea) etc., famous psychosomatists in Asian countries. Thereafter academic congresses of the Asian Chapter of ICPM (ICPM-AC) from the 2^<nd> to the 9^<th> have been held approximately every two years in Japan or in other Asaian countries namely India, Malaysia, Taiwan, South-Korea, China, and renewal congresses with changed name of the Asian College of Psychosomatic Medicine (ACPM) from the 10^<th> to the 14^<th> have been held in Taiwan, Okinawa (Japan), Australia, South-Korea and China. Present President of the Official Board of ACPM is Professor Chiharu Kubo, the Director of Kyushu University Hospital, Japan. The 14^<th> Congress was held by President, Professor ZHAO Zhifu in Beijing, China, on September 10-12, 2010. The next academic congress of the 15^<th> ACPM will be held by President, Professor Tserenkhuugyin LKHAGVASUREN in Ulaanbaatar, Mongolia, August 24-26, 2012. During about 30 years after establishment, participating countries have been widely expanded to Asian-Oceanic countries including Mongolia, Micronesia, Australia, Canada and Sri Lanka. The main theme of each congress from the 1^<st> to the 14^<th> is very attractive with various full variety, and presentations also cover a wide range such as not only general psychosomatic disorders, panic disorders, depression, culturebounded syndrome etc. from the viewpoint of psychosomatics, but also fundamental experimental researches, public health researches, psychotherapies, oriental medicine, complementary alternative medicine, social psychosomatics, and spiritualities etc. It is expected that ACPM should pay more attention to the importance of mental health which will create and improve somatic health, that is, to "health promotion" which generates health by leveling up mental health on the basis of psychosomatic correlative mechanisms (mind/body relationship) of psycho-neuroendocrinoimmunomodulation. Prevention of psychosomatic disorders is also very important in Asian-Oceanic areas from the psychosomatic and cultural viewpoints. Above all things, an awareness of existential authentic health is a sure way to bring forth healthy longevity and psychosomatic well-being in life. To pursue happiness with well-being subjectively, objectively and ecologically will be the most important purpose of ACPM in the future.

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Relationships between eating disorder and comorbid mood disorder or anxiety disorder have been drawing attention, because studying these comorbidities might facilitate and understanding of the pathogenesis of eating disorder as it has for mood disorder spectrum disorder and obsessive compulsive spectrum disorder. In contrast, few previous studies investigated the relationship between eating disorder and social anxiety disorder (SAD). However, the concept of SAD has dramatically progressed from public speaking phobia into generalized social anxiety disorder (GSAD) during the past decade, and GSAD responses well to psychopharmacology. The current study presents the preliminary analysis in our experiences of treating women with comorbid eating disorder and SAD. Subjects consisted of 266 women with eating disorders. All subjects underwent a direct semi-structured interview including SCID-I and II for DSM-IV. Ninety-one (34%) had comorbid social anxiety disorder, and most of these had GSADs. Onset of SAD preceded eating disorder in all cases. Women with comorbid eating disorder and SAD frequently showed self-mutilation and suicide attempt, and were referred as having borderline personality disorder. However, they showed a favorable course with combination of psychotherapy and psychopharmacology. This preliminary finding suggests the importance of recognizing previously undiagnosed SAD among patients with eating disorder from a therapeutic perspective.

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Introduction: The number of patients with an eating disorder complicated by schizophrenia is reportedly small; that is approximately 0.4% of the total patients with an eating disorder. In clinical practice, the complication of schizophrenia is often suspected in patients with severe and intractable symptoms of eating disorder. At Kitasato University East Hospital, we encountered patients who first presented with symptoms of eating disorder and then were definitively diagnosed as having schizophrenia. We report these cases here. Method: The study subjects were 12 patients who were referred to the Department of Psychiatry, Kitasato University East Hospital as outpatients with an eating disorder from April 2004 to December 2009 and were diagnosed as having schizophrenia as a complicating disorder. They first presented typical symptoms of eating disorder and later the symptoms of schizophrenia became evident. Therefore, initially they were not diagnosed as having schizophrenia. The first diagnoses of these patients were anorexia nervosa of the restricting (AN-R) type (five patients), anorexia nervosa of the binge eating/purging (AN-BP) type (four patients), and bulimia nervosa (BN) (three patients). Results and Discussion: Seven patients who were treated at our hospital from the initial stage of onset of AN-R type, AN-BP type, or BN were definitively diagnosed as having schizophrenia one to two years from the onset. The psychological symptoms of these patients were relatively stabilized by pharmacotherapy and their social adjustment was worse than that of the patients with an eating disorder but without schizophrenia. The therapeutic method adopted at a hospital should be determined considering the psychological symptoms of the patients. It is considered that the treatment of eating disorder should precede that of schizophrenia when obsessive persistency such as fat phobia and hyperactivity are involved even though schizophrenia is suspected. The patients were very sensitive to subtle stimulations and environmental changes, and commonly characterized by affective lability. For patients who present typical eating disorder symptoms and tend to have the above-mentioned characteristics, pharmacotherapy should be applied by carefully considering the psychopathic symptoms.

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Recently patients with eating disorders (ED) have increased rapidly in this ward. They fiercely refuse our help, but treatments for ED must be carried out in this correctional institution. But finally any patients who had long severe ED history attained safety weight and obviously reduced abnormal behaviors related to ED. We have treated 63 of ED patients for 4 years, 84% of them had at least one personality disorder diagnosis during our inpatient treatments. Personality pathology is very common among acutely ill patients with ED. As symptoms of ED improve, personality disorders vary. In most patients had already been pointed out before imprisonment that the root of their incurable ED correlate with personality disorders. We regard personality trait as the most important factor when we plan a strategy for ED treatments. Patients of our facilities can be classified into groups according to their criminal act, and there are evident differences between these groups in personality traits, impulsivities, addictions, clinical symptoms, educational background, and so on. Personality characteristics of patients with ED are represented in both impulsiveness and compulsiveness. We have also supported a three-cluster personality typology consisted of undercontrolled type over-controlled type, and resilient type. This paper reviews recent research findings regarding dimensional personality disorders and traits in patients with ED referring to Annual Review of Eating Disorders (Academy For Eating Disorders) and recent related studies.

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Taking cases of eating disorder with developmental disorder, the author described about their characteristics and how to deal with them. In childhood cases, it is quite important to listen to the process of their development, to carry out various psychological tests including a developmental test, to differentiate diagnosis on developmental disorder and to grasp the patien's characteristics. In adulthood cases, it is often difficult to get information on childhood and to make a diagnosis on developmental disorder. When we don't reach a final diagnosis due to a lack of information, it is necessary to approach them by paying attention to individual characteristics

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Psychosomatic treatment means encouraging patients to have their own insight into mind-body relations. We found that some eating disorder patients were much obsessed with their own physical symptoms, eating activities and emotions. Most of them lack motivation for receiving treatment and also strongly resist to get treatment. Among those patients, we found some cases who had no awareness of mind-body relations or did not give much thought of it. They showed such characteristics as unclear and slow talking, being paranoid with poor communication and unstable emotions. In terms of psycho-social background, they are also characterized by maladaptation to the society and poor performance at schools. Some even have problems of family background which is far short of understanding by their parents. We performed the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) to both out-and in-patients who consented to it. The result showed that the range of Full Intelligence Quotient (FIQ) of many patients fell into 55-79, which means challenged or borderline (below average) levels. Although we think it effective to treat those patients together with drugs and repeated short term hospitalization and participation of their families, it is still very difficult to change their recognition.

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The diagnosis or the treatment of PADAM (partial androgen deficiency in aging men) has not been established yet. PADAM patients often complicate mood or anxiety disorders. The objective of this study was to evaluate the long-term effect of long-term paroxetine to mood or anxiety disorder complicated with PADAM. One hundred and eight male patients who had visited to our outpatient department of PADAM and had been treated with paroxetine were investigated. Patients were divided three groups by paroxetine treatment condition; short-term treatment group (<1 year, n=37), long-term treatment group (≧1 year, n=18) and continuing treatment group (n=36) . The SDS score before treatment by paroxetine was significantly lower in the long-term treatment group than other groups, but age, trait anxiety, state anxiety, ratio of major depression, and IIEF score were not different. The reasons of difficulty to reduce paroxetine dose in long-term treatment group and continuing treatment group were deterioration of the physical symptoms (n=10, n=17), or psychological symptoms (n=7, n=7) and anxiety to decrease of dosage (n=1, n=5), respectively. At present, twenty-nine patients in continuing group who tried to reduce paroxetine dose can control by low dose paroxetine. Basically SSRI such as paroxetine should not be used for long term, but some patients are necessary to continue administration of low dose SSRI depend on one's condition.

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Background: The author thinks that almost all doctors consider clinical ethical aspects, during the doctors'diagnosing disease, offering advise and providing treatment. But there are not a form nor the custom of descripting the clinical ethical aspects. Therefore no doctors mention it. The medical care is a set of versatile procedures to aim at the improvement of the patient through various considerations for medical diagnosis and treatment, evaluation and care of psychological and social aspects. It is my opinion that we had better mention not only the medical aspects but also the clinical ethical aspects, in future medical care. The purpose of this article is to extract the clinical ethical problems concerning the nutritional channel selection through two cases of aged patients with dysphagia, using the case examination sheet made by Albert R Jonsen. Subjects & Methods: The subjects were two aged patients with disphagia. We explained the course and treatment of the disease to the surrogates. Then we asked what kind of treatment the surrogates wished to be given by paying respect to their autonomy. Simultaneously, we evaluated the cases, using the case examination sheet made by Albert R Jonsen. We report the clinical ethical aspects of these two cases. Results: The ethical problem of the two cases is that the patients could not indicate their intensions in the case examination sheets. Their son and daughter became their surrogates. The surrogate of the first case wanted to use possible means including tube feeding. The surrogate of the second case thought it important that the patient wanted to eat. The tube feeding was chosen in first case, and oral intake was chosen in the second case. Several months later, they died of pneumonia and bronchitis. Conclusion: The patients' relatives became their surrogates because the patients could not indicate their intensions. They felt they were held responsible for their surrogate decision making of treatment.

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