産婦人科領域より(心身症の薬物療法-理論と実践(臨床面))

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Various hormonal drugs, autonomic regulators and anxiolytic drugs were administered to 939 patients with climacteric disturbances, vegetative neurosis and menstrual difficulty all having unidentified complaints, and the efficacy of these drugs were compared between those having psychological factors and those having no psychological factors. As the result, they were found less effective in those patients having psychological factors which were related to the onset of illness.The patients with the same diagnosis were classified according to the theory of Alvan R. Feinstein who was introduced by T.Doi to Japan. That is, our 255 female patients with unidentified complaints were grouped into the following four clinical stages : 1) those having only psychological symptoms, 2) those having only physical symptoms, 3) those having both psychological and physical symptoms and 4) those having no symptoms despite suspected illness.Furthermore, these patients were classfied according to their motivatino for treatment into the following four types : 1) those wishing to knwo of their illness, 2) those having fear of discovering their illness, 3) those rejecting to know of their illness and 4) those who did not fall into the above three categories.Combinatinos of these 2 classifications resulted in 15 detailed clinical stages, and each patient was located on the most suitable spot on the spectrum. It was found that the efficacy of hormonal drugs, anxiolytic drugs and anti-depressants administered was different on different stages. It was also confirmed that on which stages the patients with vegetative neurosis, psychosomatic disorders and depression were tended to be located. It is our opinion that this approach is very practical in the drug therapy for psychosomatic disorders as it provides us with the standard of selection for most suitable drugs.
日本心身医学会の論文
1979-02-01

産婦人科領域より(心身症の薬物療法-理論と実践(臨床面))

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