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2012 Volume 52 Issue 4 Pages
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Article type: Index
2012 Volume 52 Issue 4 Pages
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Article type: Index
2012 Volume 52 Issue 4 Pages
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Article type: Appendix
2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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Mitsue Fujita
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2012 Volume 52 Issue 4 Pages
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Article type: Article
2012 Volume 52 Issue 4 Pages
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Toshihiko Nagata
Article type: Article
2012 Volume 52 Issue 4 Pages
277-285
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The psychopathogy of eating disorders has been rapidly changing and expanding since introduction of bulimia nervosa as an ominous variant of anorexia nervosa three decades ago. Most guidelines now recommend cognitive-behavioral treatment for bulimia nervosa (CBT-BN) as a first choice of treatment for bulimia nervosa. Because of the increasing complexity of psychopathology, CBT-enhanced (CBT-E) that addresses mood intolerance, clinical perfectionism, low self-esteem, and interpersonal difficulties in addition to the eating disorder symptoms themselves is being newly proposed. Family-based treatment for adolescents with anorexia nervosa or interpersonal psychotherapy for bulimia nervosa should be considered if appropriate. Eating disorder patients currently being treated as our facility have a considerably greater number of comorbid disorders such as generalized social anxiety disorder and multi-impulsivity. For these patients, more specific treatment such as CBT for social anxiety disorder or dialectical behavior therapy should be considered.
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Mari Hotta Suzuki
Article type: Article
2012 Volume 52 Issue 4 Pages
286-295
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Medical treatment has an important role as much as psychological therapy in eating disorders. Since eating disorders have been common diseases and there are not enough numbers of medical institutions for eating disorders in Japan, non-professional physicians also have to see those patients. However, there have been much confusion in decision of severity of disease, urgent hospitalization, and limitations of exercise for eating disorders. Therefore, the Survey Committee for Eating Disorders of the Japanese Ministry of Health, Labor and Welfare issued two guidelines about emergency medical cares for eating disorders and primary care for anorexia nervosa in 2007. It is often difficult for physicians to maintain a therapeutic relationship to patients with eating disorders due to their poor consciousness or awareness of being ill and weak motivation to gain body weight or reduce purging behavior. Further, the more medical treatment a patient needs, the more severe the psychiatric symptoms due to starvation become. In the medical treatment for eating disorders, we have to make it to strongly motivate patients with eating disorders to accept body weight gain by psycho-education. We also promote nutritional counseling based on the eating disorder-specific psychosis and eating behaviors, secure refeeding support, prevention of sequelae including of short stature, osteoporosis or teeth loss, shorten hospital stays or an assistance to the chronic protracted with home parenteral nutrition.
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Naho Tamura, Toshio Ishikawa
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2012 Volume 52 Issue 4 Pages
296-302
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In the treatment for eating disorders (ED), it is very important to build a network of medical treatment. Because patients with ED may have a variety of physical and mental complications, they need to receive treatment of different departments depending on the condition of their diseases. We have studied on the network of medical treatment for ED as the national project during these ten years. In the recent study, we investigated into all emergency centres in Japan in order to set up a medical network between medical specialists of ED and emergency staffs. As a result it became clear that emergency physicians need a list of treatment facilities for ED for co-operative relationships. Therefore, we published the second edition of emergency manual for treatment of patients with ED. In addition, we posted a booklet, which contains a list of 112 treatment facilities of ED. Finally, we distributed this booklet to all of national emergency centers and treatment facilities of ED in Japan. The above studies are our attempt of developing a medical network between medical specialists of ED and emergency staffs. We will need to build various medical networks for the treatment of ED, for example between general physicians and specialists of ED, general psychiatrists and specialists of ED, and so forth.
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Masahiro Hashizume, Ai Iwasaki, Miyuki Odawara, Yuichi Amano, Koji Tsu ...
Article type: Article
2012 Volume 52 Issue 4 Pages
303-308
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It was reported that pervasive developmental disorders showed the co-morbid conditions of psychiatric disorders. However, the co-morbidity of eating disorders in pervasive developmental disorders remained unclear. We investigated the relationship between eating disorders and autism spectrum disorders. Eighty-four patients with eating disorders were compared with a healthy control by a self-rating questionnaire. The total scores of autism-spectrum quotient of eating disorders were significantly higher than control subjects. In regard to the type of eating disorders, anorexia nervosa demonstrated the higher scores in the total scores of autism-spectrum quotient and in the item of "attention to details". In eating disorders, the detailed assessment of autism spectrum disorders is important.
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Yusuke Miwa, Michio Hosaka, Daisuke Matsushima, Hidekazu Furuya, Kumik ...
Article type: Article
2012 Volume 52 Issue 4 Pages
309-314
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Objectives: To examine the biologics agent treatment which induced changes in HR-QoL and depression in patients with RA. Methods: The age, sexuality, dosage of steroid and depression scale were assessed using the Hamilton Depression rating scale (HAM-D) and the self-rating depression scale (SDS) in 32 RA patients at baseline and after 14 weeks later by use of infliximab (17 patients), etanercept (5 patients), tocilizmab (5 patients) or adalimumab (5 patients) therapy. Disease activity in patients was evaluated using the disease activity score (DAS) 28, while the patients' HR-QoL was evaluated using a modified health assessment questionnaire (mHAQ) and Short Form (SF)-36. Based on the EULAR improvement criteria for RA, patients were classified into three groups: good and moderate response to treatment (26 patients) and no response to treatment (4 patients). Results: Following biologics agent therapy, all 8 categories of the SF-36 score were significantly improved, mHAQ improved from 0.50±0.46 (mean±SD) to 0.17±0.30 (p<0.0001), HAM-D (17) score improved from 6.3±5.1 to 3.1±3.2 (p=0.0069) and SDS scores improved from 39.0±9.7 to 33.8±10.3 (p=0.008) in the good and moderate response group. By contrast, none of these parameters showed improvement in the no response group. Moreover, the SDS score were worsening compared with before treatment. Conclusions: Our results show that good treatment-response as measured by the EULAR response criteria translates into improved depression and HR-QoL dimensions.
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Tetsuya Kondo
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2012 Volume 52 Issue 4 Pages
315-321
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A patient with fibromyalgia, who had been treated for 10 years and been unable to work for more than 12 hours per week, asked for acupuncture therapy. However, the therapy was disturbed by a hyperreactive action of the patient against the minimum touch by the acupuncturist, due to systemic hyperalgesia. The game of Why Don't You-Yes, But was found between the patient and therapists. Searching for tender points, which is necessary and essential for acupuncture therapy, was of assistance to quitting this game and enabled the threrpy to relieve symptoms such as general fatigue. As a result, the patient acquired ability to work for 23 hours per week in addition to relief of pressure pain. It was suggested that acupuncture therapy is suited for treating a chronic pain patient expositing remarkable pain.
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Daisuke Fujisawa
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2012 Volume 52 Issue 4 Pages
322-328
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
334-335
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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2012 Volume 52 Issue 4 Pages
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Article type: Appendix
2012 Volume 52 Issue 4 Pages
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Article type: Appendix
2012 Volume 52 Issue 4 Pages
347-349
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