It is important to support the transition from pediatric to adult care in the field of psychosomatic medicine. Lifestyle and common diseases tend to be different in children and adults. Therefore, it is important to adapt health care and developmental support to life stages of the patients for improving the prognosis of chronic diseases.

Health care transition from pediatric to adult health care not only helps to achieve the patients’ independence from their parents but also has a therapeutic effect by itself.

Pediatricians should cooperate with specialists of psychosomatic medicine to promote the successful transition of adult patients of childhood-onset psychosomatic diseases.

In order to facilitate a transition from pediatrics to psychosomatic medicine, we had held joint conferences with pediatricians by sharing its details and difficulties and discussing various aspects which were shown before and after transition. One of the fruits of the conferences was that we could build face-to-face a relationship with pediatricians. Regardless of this relationship, however, having concern about the differences of medical treatment between psychosomatic medicine and pediatrics will let us imagine the burdens that patients feel in transition, which will help us promote transition positively.

A transition from pediatrics to psychosomatic medicine needs careful plans in its preparation. They include kind and careful instructions and explanations from pediatrics and psychosomatic medicine, joint conference, and face to face collaboration. It is expected that this precious trial will spread nationwide.

The cut-off time for pediatric service use is the junior high school period, in general. Senior high school students are within the scope of internal medicine, but there is no medical reason for such a shift. The difference between ‘pediatric psychosomatic medicine’ and ‘psychosomatic medicine’ may answer the question : who should deal with psychosomatic disorders in senior high school students, pediatricians or internists? Compared with those of adults, children’s bodies and minds are still developing. As their psychological stress tends to be manifested as somatic symptoms, children are subject to more extensive psychosomatic disorders. Therefore, pediatric psychosomatic disorders are frequently dealt with by pediatricians in general practice. Furthermore, as children are going through developmental processes, child development should be considered at all times when dealing with such disorders. In this respect, it may be more appropriate for senior high school students to be treated by pediatricians, based on the fact that they are still undergoing the process of development that began in childhood.

Of the 160 high school students who visited the author’s private clinic during the past 12 years, 117 subjects who needed psychosomatic treatment were examined. Approximately 65% of them were referred from other medical facilities or schools. The most frequent complaints are school refusal and sleep disturbance. The most common diagnoses in somatic disorders included irritable bowel syndrome, tension headache, orthostatic dysregulation, hyperventilation syndrome, allergic disease, eating disorder etc., and in mental disorders included mood disorder, anxiety disorder, adjustment disorder, developmental disorder, etc. Medication and counseling by the psychotherapist were employed as choice of treatment. The number of their visits was once or twice in 39%, most of them dropped out of the treatment. More than half of the patients completed treatment within 2 years, and 63% of them showed improvement in symptoms. The author discussed issues of early-dropout cases and a transition from pediatric to psychosomatic care.

Background : The usefulness of MBSR has been demonstrated in healthy subjects and patients with various disorders. The feasibility and effects of the mindfulness meditation training used in MBSR were assessed in an eight week program in Japanese subjects primarily with chronic medical conditions.

Methods : The program consisted of weekly 1.5-hour group sessions and daily 30-minute home practice guided by 3 meditation CDs (translated version of Jon Kabat-Zinn). The training is designed to cultivate the capability 1) to focus/maintain attention to a single object, e. g., one breath at a time, 2) to let go of thoughts/emotions/bodily sensations occurring in the mind and returning to the original object, and 3) to distinguish thoughts/emotions from sensations on symptoms. Each CD provided a practical guide to focus attention on body parts (body scan CD), breath/posture/sounds/thoughts/emotions and others while sitting (sitting meditation CD) or body movements (yoga CD). Subjects were recruited by use of posters in the hospital or by recommendation by the author. QOL was evaluated with the SF-36v2.

Results : Fifteen subjects (M/F : 4/11, mean (±SD) age : 61±12 yrs, with diagnoses including : gastric/breast cancers, diabetes, cerebral infarction, asthma, mixed connective tissue disease (MCTD) and others participated in the program. The final evaluations were possible in 13 of 15 patients (87%). The mean frequency of the practice was 4.6±1.6 times per week with a mean of 33±14 minutes each. SF-36 results were evaluable for 12 subjects, and showed significant improvements in the “role physical” subscale (Japanese norm-based score : 29.7±19.7 to 42.0±13.0, p=0.008) and the role/social component summary score (36.3±15.4 to 47.7±9.8, p=0.04). Large/moderate effect sizes (Cohen’s d≥0.5) were observed in the “role physical” (0.92), “vitality” (0.62) subscales and the role/social component summary score (0.66). An MCTD patient made a statement that “I am no longer being captured by pain” which may suggest the mechanism of the symptomatic improvement.

Conclusion : The feasibility and effects in Japanese patients were indicated. Thus further investigations are warranted with the use of the appropriate study design and the sample size.

Humanitude^® is a care method for dementia, which was created by Yves Gineste and Rosette Marescotti.

In this paper, first, I explained the origin of the word of Humanitude^® by introducing the historical meaning of negritude. Secondly, an outline of Humanitude^® was described. Lastly, Humanitude^® was observed from the point of view of therapeutic self, multimodal communication care and oxytocin.

Since Japan has now become a society composed largely of elderly people, the usefulness of Humanitude^® will be recognized more and more. Learning and practicing the philosophy of Humanitude^® will help us remember and reconsider the meaning of human bonds, which is the most basic and important aspect of our lives, yet often forgotten in the modern society. It will be expected that we are able to realize Utopia where people treat each other with respect and dignity.