Objectives : The purpose of this study was to examine the effects of improving insomnia symptoms of university students in each intervention using a systematic review and meta-analysis.

Method : We searched PubMed, PsycINFO, CiNii, and Medical Online for articles, extracting 989 studies. Seven studies were included in the systematic review, and six of the seven were included in the meta-analysis.

Results : As a result of the systematic review, the interventions for university students with insomnia symptoms were cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene education, and cognitive refocus treatment. Results of the meta-analysis showed that CBT-I significantly improved insomnia symptom (Hedges’ g=−0.78) after treatment as compared to a control group. On the other hand, sleep hygiene education did not significantly improve insomnia symptoms (Hedges’ g=−0.21) after treatment as compared to a control group. It was not possible to conduct a meta-analysis on cognitive refocus treatment.

Conclusion : The findings of this study indicate that CBT-I is effective in improving insomnia symptoms in university students, and it is argued that CBT-I may be effective even at a low level, that is, at low intensity, in a stepped care model. Sleep hygiene education should be provided at different levels of severity, and cognitive refocus treatment should be evaluated in multiple randomized controlled trials.

Asthma and chronic obstructive pulmonary disease (COPD) are psychosomatic respiratory diseases. When physical factors impacting the disease are significant, a “body to mind” psychosomatic approach is needed. In the psychosomatic correlates of asthma, particularly in patients with severe refractory asthma, enhanced physical treatment may lead to psychological stability, reducing chronic stress reactions.

Bronchial thermoplasty and molecular targeted drug therapy have been shown to improve depression and quality of life in patients with severe asthma. However, since these therapies require invasive or expensive long-term treatment, evaluating the psychosocial burden will be vital in the future.

Holistic care, including respiratory rehabilitation and inhalers, is important for treating depression associated with COPD.

In the psychosomatic approach, it may be difficult to timeously intervene with a psychological approach when physical symptoms are prominent. In such cases, the “body to mind” approach may be practical.

Depression is common in patients with heart disease. We reviewed the prevalence and possible mechanisms of depression in patients with heart disease, the impact of depression on cardiac prognosis, and potential therapeutic approaches to treat these patients. Depression and heart disease often coexist with one leading to the other. Various biological and behavioral mechanisms have been proposed to explain the association between heart disease and depression, including autonomic nervous system activity, inflammatory changes, platelet and endothelial dysfunction, and health-related behaviors. In 2008, the American Heart Association recommended routine screening for clinical depression in patients with coronary heart disease. Although no single intervention has been established as the standardized treatment, recent studies suggest that collaborative care (depression monitoring and stepped care approach) improves depressive symptoms and cardiac outcomes. These trends suggest that it is important to establish a care network between cardiology and psychosomatic medicine.

Gut microbiota has been shown to influence various diseases, and it has become clear that it is also associated with the pathophysiology of irritable bowel syndrome (IBS). Gut microbiota dysbiosis increases mucosal permeability and sensitizes visceral nociception, while sensory irritation occurs in the central nervous system through the spinal nerve. Abnormal brain processing causes IBS symptoms. It is important to understand the concept of the brain-gut-microbiota axis to understand the pathophysiology of IBS.

Probiotics, antibiotics, and fecal microbiota transplantation (FMT) are gradually performed to treat the altered gut microbiota of IBS, but antibiotics and FMT are not covered by insurance in Japan. Further investigations are expected.

Insight regarding the mechanism of chronic pain without a diagnosed underlying disease is expanding, particularly where neuroinflammation is concerned. Neuroinflammation occurs in the central nervous system. Recent understanding of neuroinflammation has developed dramatically for some diseases. New therapies, such as anti-C5 antibody therapy for neuromyelitis optica spectrum disorders, have been introduced into clinical practice to target neuroinflammation. The association between glial activation and inflammatory mediators in chronic pain has long been studied. Inflammatory mediators produced by activated glial cells in the central nervous system enhance neural activity, resulting in hypersensitivity.

The 18kDa-translocator protein is an emerging ligand used in PET studies to show glial activation. Stronger PET signals have been detected in certain brain areas of study participants with chronic pain. Such studies are expected to deepen our understanding of the pathophysiology of chronic pain.

Synaptic pruning is a phenomenon through which synapses are eliminated by glial cells. It is believed to be associated with the development of schizophrenia and autism spectrum disorders, and studies show it is related to learning and memory. Synaptic pruning may also play a role in some types of chronic pain. Big data studies of genes related to chronic pain indicate common risk factors, including depression, post-traumatic stress disorder, and autoimmune diseases. Understanding of the chronic pain mechanisms is deepening, and the development of new biomarkers and treatments that are useful in the clinical setting can be expected in the near future.

This article reviews the pathogenesis and psychosomatic correlates of anorexia nervosa (AN), one of the most common endocrine psychosomatic disorders. The hypothalamic-pituitary-adrenal (HPA) axis is a major component of the stress system, and the HPA axis is activated by the effects of starvation in AN. The hypothalamic-pituitary-gonadal axis and the growth hormone-insulin-like growth factor-1 axis are also abnormal in AN. Furthermore, feeding-regulation hormones, cytokines, and the autonomic nervous system are altered in AN. Recently, functional brain imaging analysis and findings from gut microbiota studies have provided new insights into the cognitive and behavioral features of AN. AN is classified as a psychiatric disorder with a core pathology of desire for thinness and fear of weight gain. However, the bio-psycho-social perspective is important for understanding the pathogenesis of AN. It is expected that further elucidation of the pathological mechanisms of AN will be achieved through the development and integration of each research field.

Depression is the most common complication reported in about 15% of patients with rheumatoid arthritis. Oxytocin, known as the “Happy Hormone,” has been associated with various psychiatric disorders such as depression, schizophrenia, autism, eating disorders, developmental disorders, and post-traumatic stress disorder ; few reports associate it with autoimmune diseases such as rheumatoid arthritis. In rheumatoid arthritis, no factor has reportedly been related to serum oxytocin concentration. Serum oxytocin levels may be affected by problems with the measurement system, therapeutic agents, and the disease itself. Clinical application to depression in rheumatoid arthritis requires careful judgment.

It is well-known that chronic tinnitus is difficult to mitigate when anxiety and depression coexist, and cognitive-behavioral therapy is recommended as a treatment. In this study, we report the effectiveness of a program incorporating martial arts elements into acceptance and commitment therapy (ACT), a third-generation cognitive-behavioral therapy, for a woman in her 40s with chronic tinnitus who failed to reach remission through tinnitus retraining therapy. Eight ACT sessions incorporating martial arts elements were conducted for 90 minutes every week. The maximum intervention effect was achieved after six months, and the Tinnitus Handicap Inventory improved to a score indicating no handicap. In this case, it was considered that the incorporated martial arts elements effectively promoted each ACT process. To date, there have been no reports of ACT that employed physical experience or physical manipulation of martial arts as experiential exercises, and to the best of our knowledge, this study is the first to do so.