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2013 Volume 53 Issue 1 Pages
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Article type: Cover
2013 Volume 53 Issue 1 Pages
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Article type: Index
2013 Volume 53 Issue 1 Pages
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Article type: Index
2013 Volume 53 Issue 1 Pages
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Article type: Appendix
2013 Volume 53 Issue 1 Pages
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Article type: Appendix
2013 Volume 53 Issue 1 Pages
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Article type: Appendix
2013 Volume 53 Issue 1 Pages
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Article type: Appendix
2013 Volume 53 Issue 1 Pages
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Jun Suzuki
Article type: Article
2013 Volume 53 Issue 1 Pages
9-10
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[in Japanese]
Article type: Article
2013 Volume 53 Issue 1 Pages
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Masato Takii
Article type: Article
2013 Volume 53 Issue 1 Pages
12-19
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Type 1 diabetes is a burdensome disease because of its early age onset, the necessity of injecting insulin, society's lack of understanding and compassion for people who are "different". For these reasons, the psychosocial problems of type 1 diabetes patients are frequented and generally severe. Of 250 type 1 diabetes patients with psychosocial problems who were referred to our department, approximately 70% had a concurrent clinical eating disorder. It has been reported that about 10% of young female type 1 diabetes patients have an eating disorder, which leads to severe medical problems such as very poor glycemic control and the early emergence and development of diabetic complications. Self-destructive behaviors, such as the inappropriate use of insulin, are also severe problems for these patients. In this paper, the author mainly discusses the appearance of and treatment measures for these two problems.
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Takehiro Nozaki, Nobuyuki Sudo
Article type: Article
2013 Volume 53 Issue 1 Pages
20-28
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Diet and exercise are important components of any treatment for type 2 diabetes, a life-style related disease with serious consequences. Appropriate self-management is imperative for both diet and exercise. However, psychosocial factors determine to no small extent whether or not self-management is successful. Therefore, a psychosomatic medicine-based approach in which a therapist sees a patient from the standpoints of both mind and body would seem to have the potential to contribute much to the treatment of diabetes. First, we discuss a psychosomatic medicine-based approach to the treatment of patients with type 2 diabetes. Next, follow-up data on the psychosocial factors that influence the glycemic control of type 2 diabetic patients is shown. Finally, we present a case that illustrates the psychosomatic medicine-based treatment of an obese patient with type 2 diabetes and binge eating disorder.
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Natsue Shimizu, Yoshiyuki Muramatsu, Ichiei Narita
Article type: Article
2013 Volume 53 Issue 1 Pages
29-35
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Sleep disorders are common in diabetic patients. Many studies have reported the existence of a correlation between diabetes and sleep disorders. It has been estimated that approximately 40% of outpatients who visit diabetologists have a sleep disorder. Diabetes-associated causes of sleep disorders have been suggested to include poor control of the glucose levels, diabetic neuropathy, autonomic disorders and anxiety related to the possibility for hypoglycemic coma. On the other hand, chronic lack of sleep and poor sleep quality may contribute to the development and progression of diabetes. Additionally, many endocrine-related disorders lead to poor control of the glycemic levels. Depression and sleep apnea syndrome (SAS) are also strong risk factors associated with sleep disorders in diabetic patients. Depression is a risk factor for diabetes, and diabetes increases the risk for the onset of depression. Obstructive sleep apnea syndrome is very common in diabetic patients and may be directly linked to risks associated with diabetes and worsen diabetes control. There is evidence that obesity and SAS are strongly connected. However, it is possible for non-obese Japanese patients to have SAS. It has been reported that alexisomic features are observed in diabetic patients. Because these patients may not notice subjective sleep complaints, their symptoms must be treated with psychosomatic therapy. Providing basic education of good sleep habits is very important. It is also important that diabetic patients be taught effective coping skills and receive social support through psychosomatic approach, thereby improving diabetic care management. Additionally, sleep disorders must be recognized, diagnosed and managed, and the risk of SAS and depression among diabetic patients must be evaluated.
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Koichi Yoneda, Akihiro Asakawa, Akio Inui
Article type: Article
2013 Volume 53 Issue 1 Pages
36-41
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Patients with obesity or metabolic syndrome have a difficulty in regulating of the balance between energy intake and expenditure. Stress coping is necessary in the treatment and prevention of these diseases because appetite is related with stress. It is important to choose an order-made treatment for an individual. In this report, we focus on the lifestyle modification with understanding the mechanism of the body weight regulation.
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Atsushi Fukao, Junta Takamatsu, Toshio Kawai, Akira Miyauchi, Toshiaki ...
Article type: Article
2013 Volume 53 Issue 1 Pages
42-50
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In psychosomatic medicine of thyroid diseases, it is important for clinicians to consider "Is hormone a cause? or stress a cause?" and examine each patient. It is known that both Graves' disease and Hashimoto's thyroiditis often complicate mental disorders. Nowadays depressive state and neurosis are common as psychiatric images in both diseases and are affected by not only thyroid functions but also various psychosocial factors. Recently, many researches confirmed that life events and daily hassles affect the onset of Graves' disease. On the other hand, in researches on psychosocial factors in the clinical course of Graves' disease, life events, daily hassles, depression, anxiety, alexithymia, AC scale of the egogram, and eating disorder were found as the worsening factors. Conversely, A and FC scales of the egogram were found as the improving factors.
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Nobuyuki Kobayashi, Yoshiaki Kanazawa, Fumihiko Hamakawa, Naoya Shibat ...
Article type: Article
2013 Volume 53 Issue 1 Pages
51-57
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Background : There are 2 types of functional bowel disorders related to constipation in the RomeIII criteria irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC). We attempted to compare the symptoms of these 2 disorders. Method : We asked 1309 outpatients who visited our psychosomatic clinic to complete an original symptom questionnaire based on the RomeIII criteria and the self-rating depression scale (SDS) test. Among these patients, 95 had IBS-C (men, 35 ; women, 60 ; mean age, 35.1±18.7 years) and 63 had FC (men, 18; women, 45; mean age, 46.7±20.9 years). Results : The patients with FC were significantly older (p<0.05) and took laxatives more frequently (p<0.001) than those with IBS-C. Although the FC patients showed lower frequency of abdominal pain and bowel movement than the IBS-C patients (p<0.05), stool configuration was not different between the 2 groups. There was no significant difference in the frequency of straining, sensation of incomplete evacuation, sensation of anorectal obstruction/blockage, and manual maneuvers to facilitate defecation between the FC and IBS-C patients. The purpose of consultation in IBS-C patients was abdominal symptoms itself more frequently than those in FC patients (p<0.01). SDS scores in both groups were slightly elevated, but no significant difference was observed (IBS-C, 49.7±10.8; FC, 50.8±13.7). SDS scores were significantly elevated in patients with slower 'frequency of defecation' (p<0.01) or 'lumpy or hard stool' (p<0.01) than those without. Conclusion : Although the clinical symptoms in FC patients were slightly different from those in IBS-C patients, the prevalence of symptoms that suggested evacuation disorder was similar in both groups. Severity of depression was related to abdominal symptoms rather than the difference in diagnoses.
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Kenzo Denda
Article type: Article
2013 Volume 53 Issue 1 Pages
58-64
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[in Japanese]
Article type: Article
2013 Volume 53 Issue 1 Pages
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[in Japanese]
Article type: Article
2013 Volume 53 Issue 1 Pages
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[in Japanese]
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
67-68
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[in Japanese], [in Japanese], [in Japanese]
Article type: Article
2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
69-70
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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2013 Volume 53 Issue 1 Pages
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