Autistic spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) should not be lumped under developmental disorders. They should be discussed separately for diagnoses and treatment. It is important for the diagnoses of adult ASD and ADHD and for the differential diagnoses of other mental disorders to have sufficient knowledge of symptoms and diagnoses of adult mental disorders as well as ASD and ADHD and to assess the environment and personality.

In recent years, it is said that autism spectrum disorder (ASD) is often found in the background of adult psychiatric patients. In universities, the number of students with autistic spectrum (AS) characteristics who visit Health Service Center with the problem of maladaptation is increasing. Students receiving strict diagnosis of ASD have a certain percentage, but many students are in the gray zone. We reported the clinical features of university students with AS characteristics and discussed about the supports. The disabled student support for university education was strengthened, but it is necessary to work on the problem of maladaptation. Also, it seemed important to support not only adaptation to college life but also direction after graduation.

There is increasing recognition that neurodevelopmental disorders in adults have significant needs for job assistance. But there is no consensus about what kinds of support are needed. The idea that social motivation deficits play a central role in autism spectrum disorder has gradually accepted. Also delay aversion is considered an important pathway in the development of Attention-Deficit/Hyperactivity Disorder, along with executive function deficits. In this article we reflect on the role of support for motivation in job assistance for adults with neurodevelopmental disorders.

The author specializes in family medicine and psychosomatic medicine. This article will review the following three points from the viewpoint of a family physician.

1. Similarities and differences between psychosomatic medicine and family medicine : Both of them aim for total human medical care, and emphasize not only “disease”, but also “illness”. The great strength of psychosomatic doctor is “to be able to use many psychotherapies”. On the other hand, the strength of family doctor is “the ability to examine patients comprehensively including family and life background”.

2. Psychosomatic medicine skills are useful in family medicine/general practice : Behavior change, correspondence of difficult patients, palliative care, multi-occupational cooperation, etc.

3. Framework/skill of family medicine which seems to be useful also in psychosomatic medicine : Patient-centered medical methods, family oriented approach, utilization of social capital, etc.

There are many similarities between psychosomatic medicine and family medicine, and the author realizes that better medical treatment can be provided by collaborating on both sides’ viewpoints and skills.

The training to become the general medical treatment specialists qualified by the Japanese Medical Specialty Board has started in April, 2018. “Patient-centered medical care” is one of seven skills that the specialists should acquire. Although psychosomatic medicine is useful to learn the skill, still it is not familiar to specialists in general medicine. Our division of general medicine of Kansai Medical University Hospital belongs to the department of psychosomatic medicine, and doctors in the division are skilled in psychosomatic medicine. Twenty-five to 35% of the chief complaints of the first-visit patients are caused by functional diseases. Most of them correspond to psychosomatic disorders, and it is often possible to diagnose them or complete the treatments earlier in our division than in conventional departments of general medicine. It is important for general medicine and psychosomatic medicine to compensate for each other, and we introduce our activities in this paper.

Mental health problems in children and adolescents such as developmental disorder and school absenteeism have been increasing in recent years. Moreover, there are problems that general pediatricians are not accustomed to mental health problems and the number of specialists in mental health problems in children is small. In addition, their parents often have some sort of mental health problems. Therefore, comprehensive medical practice for mental health problems in parents and children is required. In Fukuo Pediatric and Allergy Clinic, pediatrician and psychosomatic doctors collaborate to cope with early detection and prevention of mental health problems in parents and children. There were many cases that led to improvement of mental health conditions in children through support to their parents at the early stages. Comprehensive medical practice for mental health problems in parents and children requires effort to promptly find their respective psychosomatic complaints and behavior problems early from the point of general medical examination. In the future, pediatrics and psychosomatic medicine are expected to deepen their collaboration in various areas and contribute to the mental health problems in parents and children.

There are numerous diseases that require treatment by both a psychosomatic physician and a gynecologist. Moreover, patients with psychosomatic illnesses sometimes initially present to themselves gynecology practices. For example, women suffering from eating disorders often visit the gynecologist, hoping to be treated for amenorrhea. Considering treatment for premenstrual syndrome (PMS), which features various symptoms and occurs during the luteal phase, psychosomatic intervention is effective, because many women who suffer from PMS have psychosocial backgrounds.

However, psychosomatic physicians and gynecologists do not typically collaborate in clinical settings. First, most gynecologists do not have sufficient knowledge of psychosomatic medicine. Secondly, patients may feel stigmatized at the prospect of visiting a psychosomatic physician’s office. Third, physical collaboration between psychosomatic physicians and gynecologists can be difficult, as most hospitals do not feature both departments. Thus, in this article, we will consider methods for allowing gynecological and psychosomatic physicians to collaborate.

We report a case of postnatal depression treated with a solution-focused approach, showing rapid improvement. The patient was a woman in her 40’s. She was anxious and felt uneasy about child care, and consequently became depressed due to feelings of inadequacy. She consulted our clinic nine months after giving birth. The diagnosis was depressive disorder, and we initiated a solution-focused approach involving a 20 minute session provided every other week. We set a goal of her wish to be able to go out and exercise with her baby, and she set her concrete problem of being able to get on a bus, and take part in swimming lessons with her baby. With the progression of interview, her range of activities broadened gradually. She stated in therapy sessions that her depression had improved, and had become able to work and take care of her baby. It is considered that her self-efficacy had improved after a remedial period, starting with small changes, for which she was complimented, and culminating in large changes that helped her achieve a concrete, practical goal. Because the postnatal depression was reduced, we consider that the solution-focused approach was effective.