著者

梅本 丈二 安田 弘之 市来 利香 築山 能大 古谷野 潔 都 温彦

出版者

一般社団法人 日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.41, no.6, pp.457-463, 2001-08-01 (Released:2017-08-01)

参考文献数

9

被引用文献数

2

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過食症患者は嘔吐を繰り返すため, 口腔内が頻繁に食渣や胃酸にさらされることになり, 歯の脱灰, 実質欠損をきたすことが報告されている.本研究では嘔吐と歯の実質欠損に関する予備的調査を行った.嘔吐歴が4年以上の対象者は4年未満の者に比べてう蝕の既往が多かったが, 対象患者に歯牙酸蝕の所見は認められなかった.う蝕増加の既往と嘔吐との関連性はさらに今後の検討問題として残された.また歯科治療の際, 摂食障害について話すことに抵抗感があるとの質問紙に対する回答から, 摂食障害患者の自分の症状を知られたくないという心理面も窺えた.いずれにせよ, 医師・歯科医師双方が本件に留意して, 臨床にあたることが重要である.

著者

豊福 明 梅本 丈二 内藤 温友 喜久田 利弘 都 温彦

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.15, no.2, pp.197-202, 2000-12-25 (Released:2011-09-20)

参考文献数

15

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The authors employed behavior restriction therapy for a 19-year-old female delusional halitosis patient under hospitalization. She had been complaining of halitosis for 4 years and visited several psychosomatic specialists. She had also been hospitalised in a psychiatric ward for treatment but her complaints of halitosis had not been reduced. She gave up high school and tended to stay indoors.We started by using the description of impressions and prescribed her amitriptyline as an outpatient. Symptoms such as delusion of reference or depression were ameliorated and she became fairly cheerful. But her poor social adaptation hindered her from forming a full social identity.We introduced her to behavior restriction therapy upon her admission to our hospital. Under condition of general social deprivation, she experienced many warm emotional exchanges with other inpatients, and gradually gained confidence in personal relations. We also administerated fluvoxamine, a selective serotonin reuptake inhibitor (SSRI). The fluvoxamine was as effective as amitriptyline, and fewer side effects were observed. Finally, she became able to talk with others and go out freely, in a manner suited to her age.It is suggested that behavior restriction therapy was useful in this case.

著者

豊福 明 都 温彦

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.18, no.2, pp.99-101, 2003-12-25 (Released:2011-09-20)

参考文献数

7

被引用文献数

2

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外科的顎矯正治療後に, 咬合の異常感の他, 姿勢のねじれ, 全身倦怠など多彩な全身的不定愁訴を呈していた39歳, 女性の顎関節症患者に, SNRIであるmilnacipranによる治療を行った. SNRIを6ヶ月かけて30mg/dayから120mg/dayまで増量したところ, 咬合の異常感, 広範囲の疼痛や随伴症状の睡眠障害, 慢性疲労, 全身のこわばり, 痺れ感, 抑うつ気分などが, 経時的および用量依存的に改善していった. 本症例は線維筋痛症の診断基準も満たしており, 両者の随伴症状の重複や抗うつ薬への反応の共通性から, このタイプの顎関節症の背景には線維筋痛症と類似した中枢性の病態生理学的機序が存在するのではないかと考えられた.

著者

豊福 明 吉田 美紀 嶋村 知記 古賀 勉 瀬戸 富雄 清水 敏博 中小田 直子 松原 聖子 有吉 祐二 喜久田 利弘 都 温彦

出版者

Japanese Society of Psychosomatic Dentistry

雑誌

日本歯科心身医学会雑誌 (ISSN:09136681)

巻号頁・発行日

vol.11, no.1, pp.88-95, 1996-06-25 (Released:2011-09-20)

参考文献数

5

被引用文献数

1

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We have proposed that the management of serious psychosomatic TMJ disorder should be undertaken in a hospital environment where the patient can be fully investigated and the response to medication and psychotherapy monitored.This is not only because they are too tired to do anything but also they wander about many hospitals having wrong conviction that occlusion is the cause of many systemic disorders.To release the oral function from this pathological attention of brain, we reduce their symptoms by antidepressants without dealing with their occlusion. In this process, we take a psychotherapeutic method to make them notice their changes to understand that occlusion had nothing to do with patient's symptoms.A 34-year old man, complaining of TMJ disorder and systemic fatigue and many symptoms, was shown as a case example in the process of improvement of wrong conviction.Once he came to our department, but was lost to follow-up, and wandering many hospitals including neuro-pcychiatry. 8 months after the last visit, the patient came to our hospital again for admission.In the process of therapy, constant stimuli were provided to patients in the therapeutic frame, in which the therapist tried to maintain an emotionally steady attitude toward him and gave active support to his healthy mind, through stable and proper comments without being affected by perpetual and entrapping inciation of his ill mind.Comstancy not only in psychological stimuli but also bodily sensation was evaluated as one of the most important factors for the cure of the disorders. Psychosomatic therapy by the dentist made it possible for this patient to resusciate his own bodily (especially oral) perseption.