Two goals of psycho-oncology, in general, are : (1)to identify and address the psychological impacts of cancer on the patients, their families and the healthcare providers, and (2)to identify the psychological, sociological, and behavioral factors associated with the quality of life (QOL) and survival of cancer patients and develop intervention methods based on these factors. Adjustment disorders, depression and delirium have been identified as common features of the psychological distress of cancer patients that require to be treated, and evaluation and the appropriate approach to these symptoms have been widely studied. Meanwhile, various factors potentially associated with the QOL and survival of cancer patients have been investigated. The present report outlines the past findings in regard to these two goals of psycho-oncology, specifically the common psychological responses of cancer patients after cancer disclosure, diagnosis of and approach to the psychological distress requiring psychiatric treatment, and factors possibly associated with the QOL and survival of cancer patients.

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In daily psycho-oncology clinical situations, healthcare professionals face not only pure medical problems but also ethical problems. Therefore, healthcare professionals engaged in clinical practice of psycho-oncology have to get acquainted with clinical ethics review methods. Major of clinical ethics review methods consists of procedure-based and principle-based approach. Examples of procedure-based and principle-based approach are Jonsen's 4-BOX method and four basic principles of medical ethics, respectively. Definite process in clinical ethics review about each individual case is achieved by means of them.

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Delirium is a common and often serious neuropsychiatric complication in the management of cancer patients, characterized by an abrupt onset of disturbances of consciousness, attention, cognition, and perception that fluctuate over the course of the day. Psychosomatic medicine physicians who don't have specialized training for psycho-oncology are less familiar with delirium because chief complaints in cases of delirium are hallucinations and delusions which they don't deal with in clinical practice. However, it is particularly important in the diagnosis and treatment of delirium to accurately evaluate medical factors such as dehydration and infection, and thus, it is an area where psychosomatic medicine physicians who have received internal medicine training can exhibit their abilities to the fullest. A case of a 60-year-old terminal cancer patient with varied psychological distress who developed delirium will be presented, in order to distinguish adjustment disorder and depression from delirium and to discuss the diagnosis, course of treatment for delirium, and the support available to patients' families.

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Objectives : Alzheimer's disease (AD) patients are increasing. The present study examined the character in Baum Test drawn by AD patients with cognitive progression. Method : We classified 38 mild AD patients treated at our hospital into two groups by one-year changes of Minimental state examination scores : (i) Patients with cognitive progression and (ii) Patients without cognitive progression. We compared the characteristics of Baum Test between the two groups. Results : The group 1 drew the tree in significantly smaller size as compared with the group 2. Conclusion : This result suggests that the tree size in Baum Test may predict the cognitive prognosis of AD patients.

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Social anxiety disorder (SAD) is known as the most common type of Anxiety Disorder. In recent studies, it was suggested the perceived anxiety control is considered to be a maintaining factor of anxiety disorders, including SAD. Perceived anxiety control is the cognition how individuals perceive that they could control their anxiety responses. In present study, the purpose was to develop the scale to assess the perceived anxiety control, which is the maintaining factor in SAD, and clarify the characteristics of perceived anxiety control in SAD. Undergraduate students (n=251) and SAD patients (n=14) completed a set of questionnaires : the Liebowitz Social Anxiety Scale (LSAS) ; the Social Cost/Probability scale (SCOP) ; the Tri-axial Coping Scale 24-item version (TAC-24) ; and the Perceived Anxiety Control scale (PAC). Exploratory factor analysis by using maximum likelihood method and promax rotation revealed that the PAC consisted of three factors that were named : "Avoidance", "Calm", and "Desire." The Cronbach's α coefficients indicated that each factor of the PAC had a high internal consistency (alpha=.77-.83). Correlation analysis between each scale revealed that each factor score and total scores of the PAC was associated moderately with the scales of SAD symptoms (p<.01). Additionally, t-tests showed that the mean scores of the SCOP and the LSAS in SAD patients and the scores of each factor and of the PAC in SAD patients were higher than college students, except the "Calm" factor of SAD patients was lower than college students (p<.05). In addition, the total scores of PAC in SAD patients was significantly higher (p<.05). These results suggested that SAD patients had high SAD symptoms and low perceived anxiety control. In summary, the present study indicated that SAD patients had low perceived anxiety control. Future studies needs to clarify the relationship between the PAC and each component of SAD. In addition, it was required to examine the difference between SAD and other anxiety disorders.

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Objective : The objective of this psychosomatic study is to clarify the factors affecting the control of asthmatic attacks in adult patients at the department of internal medicine, and to find the methods to predict the patients who may have poor control of bronchial asthma at the early stage of medical treatment. Subjects : Thirty-two adult outpatients with bronchial asthma who were treated regularly at the department of internal medicine of Kobe City Medical Center West Hospital were submitted to this study. This study was permitted by the committee of ethics of this hospital and all the patients agreed with the aim of this investigation. Methods : The patients were divided into two groups according to the scores of the Asthma Control Test. Group I consisted of the patients who scored under 20 (poor control). Group II consisted of the patients who scored between 20 and 25 (good control). Statistical analyses were performed by t authorization between the two groups as to age, allergic factors, pulmonary functions, psychosocial factors by Psychosomatic Questionnaire and sense of coherence (abbreviated to SOC) by SOC Questionnaire of Japanese Edition. Results : The positive rate of allergic factors showed no significant differences between the two groups. Scores of psychosocial factors (psychosocial stressors, emotions, behavioral problems, familial relationship, life history etc.) especially psychosocial stressors were significantly higher in Group I than in GroupII. Scores of SOC was significantly lower in Group I than in Group II. Conclusion : It was suggested that good or poor control of asthmatic attacks could be influenced by psychosocial factors more than allergic factors. Low scores of SOC Questionnaire possibly contribute to high scores of Psychosomatic Questionnaire. At the early stage of the treatment, it might be necessary for therapists to help the patients enhance the sense of coherence, modify their distorted recognition, and avoid inadequate coping behavior in order to increase the number of patients who will have good control of asthmatic attacks.

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