Patient 1 was 30 years old female. She suffered from Graves' disease in spite of antithyroid drug treatment for 2.5 years and combined depressive state. In consequence of the treatment with supportive psychotherapy together with antithyroid drug, she has become aware of her over adaptation in personal relation and changed to be able to express her emotion properly. At last she has got both remission of hyperthyroidism and depressive state. Then she has hardly become to suffer from common cold. Patient 2 was 15 years old female, whose body weight becomes from 56kg to 38kg by a loss in weight. She has also suffered from binge eating, vomiting and amenorrhea. As a result of examination, she has been diagnosed to be a combination of Graves' disease and eating disorder. Because she could not continue antithyroid drug treatment due to phobia to weight gain, therapeutic plan has been reevaluated with her mother and she has consent subtotal thyroidectomy at last. Now she is maintaining body weight of about 40kg and stable mental state though she is replaced thyroid hormone. In conclusion, psychosomatic approach contributes to improve not only hyperthyroidism but also stress related complications in female Graves' disease patients.

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[in Japanese]

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It is possible that the menstrual cycles and attitudes of female athletes are affected by strenuous exercise or training. The present study investigated the fluctuation of sex steroids, physical symptoms and Profile of Mood States (POMS) of 12 handball players (19.8 ± 1.4 years) with regular mensturations between menstrual cycle phases (menstrual phase, follicular phase, luteal phase). 15 non-handball players (20.1 ± 1.2 years) formed a control group. Estradiol and progesterone levels in serum were measured by radioimmunoassay. The hormone levels of both subjects varied among the menstrual cycle phases, but handball players had significantly lower levels of estradiol and progesterone than controls during the luteal phase. During the menstrual phase, abdominal symptoms and breast tenderness were higher for both subjects, but handball players had less variety and a lower degree of severity of symptoms than controls. No differences were found in the scores between the phases, which suggests that the differences of the secretion of sex steroids and physical symptoms were caused by strenuous exercise or training. Further, the subjects were asked about their attitudes to menstruation by questionnaire. The result of this questionnaire was that both subjects viewed menstruation negatively, however the belief in the "menstruation as a bothersome event" was higher among Handball players.

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Psychological assessment-Inventories (POMS, Yatabe-Guilford character inventory and TEG) were adminitered on 58 young women from 18 to 30 years old. The score of POMS D, which represents recent depressive tendencies, was significantly explained by the degree of IL-6 by using stepwise-regression. The subjects who showed higher degree of IL-6 showed higher level of NTx, which is widely recognised as a specific and sensitive marker for bone resorption. The subjects who showed both of higher POMS D score and IL-6, resulted higher level of NTx. But the result of ultra-sound measurements on calcaneum bone BUA did not show significant corelations to POMS D nor to IL-6. From these, we suggested recent depressive tendency activates acute bone absorption system but this is not reflected to the result of ultara-sound measurements.

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Chronic pelvic pain is a debilitating life-altering syndrome that negatively affects a woman' s quality of life and personal relationships. A 36-year woman with persistent pelvic pain was treated with psychosomatic therapy using the Morita therapeutic approach. Leading a life without any sexual relationships, and devoting herself entirely to her job, this patient had her first sexual encounter at the age of 36. She experienced "trivial" intrapelvic discomfort at the time, which gradually became an excruciating lower abdominal pain which lead to chronic general malaise, shoulder muscle stiffness, and anxiety hold to the extent that she had difficulty in her daily activities (work, daily house/management, etc.) Adding to her nervous and hypochondriacal personality, imprudent diagnosis and explanation by a gynecologist appeared to have increased her chronic pelvic pain. Her feeling of pain progressively led to pain-prone behaviors in daily life. Basic psychotherapy was performed for 6 months, but her symptoms were never improved. She had a negative attitude toward drug therapy. Six months after the first visit, she was treated with the Morita therapeutic approach and operant conditioning technique (behavior therapy). These therapies gradually reduced her pelvic pain, and she was able to start a new constructive life with a positive attitude.

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