臨床的にみたストレス病の発症メカニズム : とくに患者側の問題点を中心に(ストレスの基礎と臨床)(第27回日本心身医学総会)

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Most of the diseases which are considered psychosomatic are socalled stress Induced diseases ("the diseases of adaptation") and bronchial asthma is one of them. The subjects of the present study consisted of those asthmatic patients who were seen at our psychosomatic department. We gave them the stressors which were assumed to participate in the development of their asthmatic attacks and examined the changes in clinical symptoms, pulmonary function and chemical mediators before and after giving the stresors. The results were summarized as follows : l. In the mirrordrawing test, 5 out of 8 cases showed an increase in plasma histamine and 3 out of them showed an increase in the _cAMP vs _cGMP ratio, but no clear asthmatic attacks appeared. 2. With regard to the listening of recorded wheezing sound, a more than 20% increase in respiratory resistance and an increase in the _cAMP vs _cGMP ratio were seen in 9 out of 16 cases, but no clear asthmatic attacks appeared. 3. In the inhalation test with a suggestion of house dust, 12 out of 23 cases showed a more than 20% decrease in FEV_1._0,but only 5 cases had asthmatic attacks. 4. In the excercise test to induce asthmatic attacks by ascending and descending stairs, 20 out of 29 cases developed asthmatic attacks. Many of these patients showed increases in plasma histamine and cortisol levels. 5. Fortyone asthmatic patients were selected from the inpatients who seemed to have difiiculties in family relationships. They were ordered to stayout at their homes in the early stage of psychosomatic treatment. Thirty-six out of 41 cases developed asthmatic attacks and many of them had a tendency to show some rise in plasma histamine levels prior to going back to their families. 6. These stress-induced asthmatic attacks did not appear in the patients who showed favorable results by psychosomatic treatment. These results indicate that the onset and course of socalled stressinduced diseases ("the diseases of adaptation") are influenced significantly, not only by the patient's predisposition, the kind and intensity of stressors and their duration, but also by the patient's perception of and coping behavior to the stressors and his psychophysiological condition under the stressors. It was keenly felt that psychosomatic treatment was indispensable for so-called stressinduced diseases.
日本心身医学会の論文
1987-01-01

臨床的にみたストレス病の発症メカニズム : とくに患者側の問題点を中心に(ストレスの基礎と臨床)(第27回日本心身医学総会)

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