Japanese Journal of Psychosomatic Medicine

There have been more than thirty thousand suicides annually in Japan since 1998, and the background for this is considered to be the global economic structural reform due to the information and telecommunication (IT) revolution. This reform has brought about substantial changes in the mode of work, sense of values, the way communication ought to be and the like of workers, so that mental health problems of wage earners have become diversified. Mental health problem-related costs have also increased and become an important issue for the management. Present-day mental health care is not merely confined to the care of workers bearing mental health problems, but has to be pro-actively grappled with as a task of the organization, under the purview of mental health management. Industrial physicians concerned with mental health are required to have broad interests in various pertinent aspects and a perceptive insight about personnel labor relations management, operations, contents of service, corporate social responsibility (CSR), laws and regulations. Such an approach from multiple viewpoints is the starting point of psychosomatic medicine, and psychosomatic medicine and occupational mental health profoundly overlap with each other in essence. Thus, much is anticipated for psychiatrists and psychosomatic physicians.

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In deadlock with an uncertain future, the number of suicides in Japan exceeded 30,000 for the first time in 1998. After that for 14 years in a row until 2011, the figure has stayed the same. Although the Ministry of Health, Labor and Welfare has considered this problem an important subject and tried to take appropriate measures, the expected results have not yet been realized. During this time, I chanced to see mentally disordered workers enduring long-time agricultural work, and the idea of utilizing agricultural experiences to improve mental health flashed into my mind. I was wondering if earth, agricultural work and being surrounded by nature have the power to rejuvenate people. Change your environment or look back over the past and you can find what you have really wanted. Through this therapy, various effects have been proven. It may be the interactive training which produces outstanding effects simply by changing the environment a little in a short period of time.

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Since 2011, the Ministry of Health, Labor and Welfare included mental disorders as one of five diseases of which measures should be intensively taken. One of the most important mental disorders is depression. Medication and rest are two most important treatments in depression. Recently, exercise is considered as an alternative efficient treatment for depression. It could be also effective for maintaining a remission state and even prevents depression. Almost all depressive patients have sleep disorders. Past studies indicate poor sleep quality could be a large risk factor of depression. It has been know that exercise improves sleep quality. Moreover, exercise also improves fitness levels which have been weaken during depressive patients' rest period. Considering all these together, exercise improves mood, sleep and physical fitness, therefore improves depressive patients both mentally and physically. However, continuing an exercise habit is difficult. Thus, the newly developed sheet type sleep monitor, and the actogram are useful to feedback the amount of physical activity and improved sleep quality that leads to continuing the exercise.

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Objective : The relation between atopic dermatitis (AD) and anxiety is well documented. Recent research has demonstrated that trait anxiety, "anxiety to itch", and anxiety sensitivity are related. However, it is not clarified that which anxiety has affected strongly on the symptoms. The aims of this study is to examine the feature of adult AD patient's anxiety and to clarify the relationship between anxiety and other characteristics. Method : Thirty-seven adult AD patients and 46 healthy adults who have no physical symptoms and/or mental disorders were selected for this study. The participants and healthy adult controls were asked to fill out the self-rating scale of the Itch Anxiety Scale for Atopic Dermatitis (IAS-AD), the Anxiety Sensitivity Inventory (ASI), the Body Vigilance Scale (BVS), and the State-Trait Anxiety Inventory-Form JYZ (STAI-JYZ). The severity of AD symptoms were rated by a dermatologist. Results : Significant differences were recognized between two groups only on the IAS-AD and the BVS. It was judged that 3 clusters were appropriate by the cluster analysis. Each cluster was named the high anxiety cluster, the low anxiety cluster, and the physical anxiety cluster. While healthy adults were found more in the low anxiety cluster, adults AD patients were more in the high anxiety and physical anxiety clusters. Conclusion : It was suggested that more attention on the specific anxiety such as "anxiety to itch" seems to be important to reduce adult AD patient's anxiety. In the future, it is necessary to construct an appropriate psychological approach based on this result.

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