Autism spectrum disorder (ASD) is a neurodevelopment disorder appearing in infancy, characterized by qualitative deficits in social interaction and communication ability, and restricted and repetitive behavior as the primary symptoms. The alteration from DSM-Ⅳ to DSM-5 is a change from a category of pervasive developmental disorders (PDDs) including several subcategories, to a unitary concept of ASD with no subcategories. Recently, the interest and demand to ASD have been increasing, but it cannot be said that enough care has been carried out. In this report, the change of concept, diagnoses and clinical characteristics, treatments, course and prognosis, and an understanding of individualities in ASD were discussed.

Attention deficit hyperactivity disorder (ADHD) is characterized mainly by hyperactivity, impulsiveness, and carelessness. Diagnoses are based on 3 cardinal symptoms included in DSM-Ⅴ. However, each of these symptoms varies markedly depending on the patient’s age ; therefore, it should be taken into consideration when making a diagnosis. Concerning differential diagnosis, it is particularly important to differentiate ADHD from autism spectrum disorder, which is challenging. Regarding treatment and support, psychosocial treatment is prioritized in which the following 4 domains are combined : environmental adjustment, psychosocial support for parents, psychosocial treatment of children, and cooperation with relevant specialized organizations (e. g., schools). If necessary, pharmacotherapy is performed, in which methylphenidate sustained-release tablets and/or atomoxetine are indicated, but they should be used with caution.

Psychosomatic symptoms and developmental problems are prevalent among children with developmental disabilities, because they cannot verbalize their feelings and tend to express them by physical symptoms. Their symptoms are often due to maladjustment of their developmental characteristics to the surrounding environment. To solve their psychosomatic and behavioral problems, we should know about the features of their development and recognition. Then we should cooperate with school teachers and ask them for consideration according to the developmental characteristics of children.

Many young patients who consult a psychiatrist on a psychosomatic physician are said to have Autism Spectrum Disorder (ASD). Particularly the adolescents with normal intelligence need a proper diagnosis. They have gone through many hardships, and became maladaptive. We discussed clinical features of the adolescents with ASD and the way to support them. We investigated the presence and change of past psychosomatic symptoms in 42 patients with developmental disorder. Many patients presented psychosomatic symptoms in childhood, and the symptoms changed into depressive symptom, anxiety symptom, eating disorder, and so on. Many cases treated in the past showed good adaptation in their youth. It may be possible to prevent secondary psychiatric symptoms in their youth when we find psychosomatic symptoms of the childhood and their early intervention. In addition, there are many similar points in eating disorder and ASD. We presented a case and discussed the relationship between eating disorder and ASD.

In this paper I describe and remark upon a number of cases exhibiting typical symptoms of various adult psychiatric problems, including psycho-somatic disease, as well as the characteristics of the developmental disorders underlying them. Conditions capable of having an underlying developmental disorder were introduced as : (1) schizophrenia-like symptoms, (2) depression or depressive state, (3) bipolar disorder, BPⅡ, (4) psycho-somatic disease, (5) hypochondria, (6) obsessive-compulsive disorder, (7) eating disorder, and (8) borderline personality disorder. For each of these psychiatric conditions, there is a risk of exacerbation or prolongation if one focuses on only the surface symptoms, and support in which taking the underlying developmental disorder into account is not provided. When making a diagnosis, continuous attention must be paid to the patient’s growth history, and any deviation in symptoms from the typical clinical manifestation should be carefully considered.

Objectives : This study attempts to examine the healing and recovery process of irritable bowel syndrome (IBS), focusing on psychosocial factors affecting symptoms. It is not uncommon for patients being treated for IBS to require long-term treatment. They also have been reported to have secondary problems such as depressive tendency and avoidance of social opportunities. In particular, since the quality of life of patients with severe IBS symptoms are associated with non-digestive rather than digestive symptoms, it is important to investigate the psychosocial factors that often prolong the course of the disease. However, the medium-long-term course, healing, and recovery process of IBS-affected individuals have not been investigated. Identifying major factors moving the IBS healing and recovery processes forward will contribute to development of efficient treatment and self-management. Subjects and method : The interview data were collected from 7 subjects (4 men, 3 women, mean age 35, type of IBS : 1 diarrhea, 6 alternate) affected by and recovered from IBS. Semi-structured interviews were conducted from July 2014, to October 2014. In the interview, we mainly focused on subjective experiences of the IBS healing and recovery process. The interview data were analyzed using the qualitative method of Trajectory equifinality model (TEM). Results : We found 3 types of healing and recovery processes for IBS. The final point of the process was set as state of subjective healing. At the beginning, every type took the same process : [affected with IBS], [obsessed with symptoms], and [coping behavior]. Next, they reached [partial healing] as a bifurcation point. After that point, there were two directions : [faced psychological problems] or [environmental control]. Through these processes, every type received some kind of support factor and then experienced the cognitive changes of [perfectionism], [outlook on life], and meaning of IBS experience. It was also suggested that the concept of [resignation], related with perfectionism, is one of the core factors move the process forward. In addition, it was also suggested that both “acceptance” and “change” factors given from medical professions, family members, and peer groups have the potential to move the process forward. ^* [ ] : Extracted concepts in the process models Conclusion : Through the analysis of the IBS healing and recovery process in this study, we found 3 types of healing and recovery processes. As a common finding of all types, cognitive changes in the meaning of IBS experience, perfectionism tendency, and outlook on life were key concepts to reach subjective healing in the process. Further study on the process may be required using a larger sample.

Objectives : We conducted a study of clinical symptoms on adolescent and adult patients with avoidant/restrictive food intake disorder (ARFID), and compared this group to groups of patients with anorexia nervosa, restricting type (AN-R) and anorexia nervosa, binge-eating/purging type (AN-BP). Subject and method : A retrospective chart review was completed on 570 patients with feeding and eating disorders. Using the DSM-5 criteria, 48 patients met the criteria for AN-R, 94 for AN-BP and 83 for ARFID. Results : The prevalence rate of ARFID was 14.6% of feeding and eating disorders. All patients with ARFID were women. The ARFID group reported younger age at entry and shorter duration of illness, compared with the AN-BP group. The ARFID group had the lowest psychopathology among the three groups. Conclusion : These findings in clinical presentation in adolescent and adult patients with ARFID are somewhat different from previous findings in pediatric patients with ARFID.