気管支喘息の心身医学的診断について : 臨床疫学を含めて(気管支喘息と心身医学)(第32回日本心身医学会総会)

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1) It is well known that the feature and prognosis of bronchial asthma are often modulated by psychosociological factors which consist of various psychopathological conditions. With a view to evaluating the diagnostic criteria for bronchial asthma influenced by psychosociological factors, the psychopathological conditions were classified into the following groups; a) The group with less psychosociological factors (Somatic asthma ; cases with no need of psychosomatic therapy), b) The group with confirmed psychosociological factors related to the initiation or physical condition (Psychosomatic asthma), (a) The group with emotionally disturbed state, but not neurotic or depressive conditions, (b) The group with neurotic conditions, (C) The group with depressive conditions. 2) The resulting classification was applied to 700 patients with bronchial asthma (356 males, 344 females, ages ; from 15 to 83,mean 47.8 years old) to assess the psychopathological conditions involved and the underlying factors was investigated. The results were summarized as follows ; a ) Psychosociological factors were found to be involved in 600 cases (86%) of the subjects. They comprised psychosociological factors without neurotic or depressive conditions (41%), neurotic conditions (26%), and depressive conditions (19%). b) Psychosociological factors, mainly neurotic and depressive conditions, were significantly associated more frequently with female than with male patients. The years of suffering were significantly longer in the psychosomatic asthma groups, mainly with neurotic and depressive conditions, than in the somatic asthma group. When the subjects were classified according to disease severity, the severe cases were present more in the psychosomatic asthma groups, mainly with neurotic and depressive conditions, than in the somatic asthma group. Furthermore, the FEV_1.0% and %VC of spirogram were significantly lower in the depression group. c) The incidence of psychosociological factors involvement did not differ according to ages and the presence of allergic factors. 3) We applied three psychological screening tests, such as Self-rating Depression Scale (SDS ; to 201 cases), Manifest Anxiety Scale (MAS ; to 197 cases) and Yatabe-Guilford test (Y-G ; to 197 cases), and two psychophysiological screening examinations, such as Cornell Medical Index (CMI ; to 700 cases) and Comprehensive Asthma Inventory (CAI ; to 700 cases). CAI which was originated by the Japanese Society of Psychosomatic Research on Respiratory Disease is a questionnaire designed to find out emotional factors concerned with asthma attack. The results obtained were summarized as follows ; SDS, MAS, and Y-G were valuable for checking the neurosis and depression, and CMI and CAI were very useful for detecting all pychopathological conditions.
日本心身医学会の論文
1992-03-01

気管支喘息の心身医学的診断について : 臨床疫学を含めて(気管支喘息と心身医学)(第32回日本心身医学会総会)

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