著者
和気 裕之 小見山 道
出版者
一般社団法人 日本顎関節学会
雑誌
日本顎関節学会雑誌 (ISSN:09153004)
巻号頁・発行日
vol.26, no.3, pp.183-190, 2014

顎関節症診療における歯科医師と精神科医の連携について述べた。顎関節症診療では,有病率の高い精神疾患に遭遇する機会が少なくない。そして,心身症の概念は身体疾患と精神疾患の境界領域の病態を理解するうえで重要である。歯科心身症には定義がなく,臨床では狭義と広義の概念で用いられている。狭義の歯科心身症は,日本心身医学会(1991)の定義に該当する歯科領域の病態を指す。一方,広義の歯科心身症は,「臨床的に説明困難な症状」や,「心身両面からの評価と対応を要する患者」などに対して用いられているが,リエゾン診療では,その70%以上が身体表現性障害に該当する。顎関節症は多因子性の疾患であるが,そのなかの心理社会的因子には不安・抑うつなどの心理状態,性格傾向,ストレス,精神疾患などがあり,これらは診断と治療を行ううえで重要である。歯科医師は顎関節症診療で,傾聴,受容,共感,支持,保証を基本姿勢としてBio-psychosocialな評価を行い,精神科との連携を要する症例は,心身医学的な医療面接から検討する。また,特に診察と検査から他覚所見がみつからない症例,あるいは自覚症状と他覚所見に乖離のある症例では注意が必要であり,単独で診療が可能か連携して診療すべきかを判断することが重要である。
著者
内山 真
出版者
日本大学医学会
雑誌
日大医学雑誌 (ISSN:00290424)
巻号頁・発行日
vol.69, no.1, pp.11-16, 2010

Epidemiologic studies have clearly shown that sleep problems are common in the general population. A survey, conducted in Japan, reported that 21.4% of adults had complaints of insomnia and that 14.9% complained of hypersomnia (excessive daytime sleepiness). In the primary care setting, however, few patients present with overt sleep complaints but rather generally present with symptoms of fatigue, excessive sleepiness, and impaired waking. Therefore, it is important for physicians to understand how to differentiate and manage the sleep complaints of the patient. Herein, the author reviewed the clinical management of insomnia and hypersomnia, together with recent pathophysiological findings on these disorders. Insomnia is currently defined as an inability to obtain an adequate amount of sleep, to feel restored and refreshed in the morning, and to function adequately in the daytime. The differential diagnosis of difficulty in sleeping includes psychophysiological, neurological and circadian causes. Pharmacological and non-pharmacological interventions are combined in the treatment of insomnia. Sleep deprivation is the most frequent cause of excessive daytime sleepiness. Narcolepsy is the most prevalent type of hypersomnia with sleep attack and cataplexy. Recent studies have indicated the pathogenetic importance of orexin/hypocretin (a peptide hormone produced in the lateral hypothalamus) dysfunction in narcolepsy.
著者
神崎 晶 小川 郁 熊崎 博一 片岡 ちなつ 田副 真美 鈴木 法臣 松崎 佐栄子 粕谷 健人 藤岡 正人 大石 直樹
出版者
一般社団法人 日本耳鼻咽喉科学会
雑誌
日本耳鼻咽喉科学会会報 (ISSN:00306622)
巻号頁・発行日
vol.123, no.3, pp.236-242, 2019

<p> 聴覚過敏を主訴とした患者に対して, ほかの感覚器の過敏症状を問診・質問票による検査をしたところ, 複数の感覚過敏を有する5例を発見した.「感覚過敏」と本論文では命名し, その臨床的特徴を報告する. 主訴に対する聴覚過敏質問票に加えて, 複数の感覚過敏に対する質問票「感覚プロファイル」を用いて過敏, 回避, 探求, 低登録について検査した. 同時に視覚過敏は5例で, 触覚過敏は4例で訴えたが, 嗅覚と味覚過敏を訴えた例はなかった. 病態には中枢における感覚制御障害が存在することが考えられる. 感覚過敏の検査法, 診断法, 治療についてはまだ確立されておらず, 今後の検討を要する.</p>
著者
三輪 徹 蓑田 涼生
出版者
一般社団法人 日本めまい平衡医学会
雑誌
Equilibrium Research (ISSN:03855716)
巻号頁・発行日
vol.78, no.2, pp.93-101, 2019
被引用文献数
3

<p> Past major earthquakes have been associated with an increase in the prevalence of vertigo or dizziness; the 2016 Kumamoto earthquakes on April 14 and 16 (JST, moment magnitude=7.0, Shindo 7 [Japanese seismic scale]) and the large numbers of aftershocks were no exception. Several months after the initial earthquake, significant outbreaks of vertigo or dizziness occurred over a large area surrounding the epicenter of the earthquake. However, it is unclear why major earthquakes cause these symptoms. After the major earthquake in Kumamoto, we conducted a questionnaire and medical records survey to investigate post-earthquake dizziness (PED). This survey covered a total of 575 subjects who complained of exacerbation of vertigo or dizziness after the earthquake and visited the hospital for follow-up before the scheduled dates. Our results showed that the number of patients with vertigo or dizziness who visited the hospital increased after the earthquake, and peaked between 2 and 4 weeks after the earthquake. The timing of onset of vestibular disorders varied according to the underlying disease. This study also suggested that earthquake-related psychological stress or stress resulting from earthquake evacuation could cause the onset of some vestibular disorders. We speculated that PED could be caused by stimulation of the vestibular and visual systems and bathyesthesia, psychological stress, potential effects of autonomic stress on the equilibrium function, and/or sensory mismatch. Our study could contribute to establishing PED as a new concept in the area of vestibular disorders.</p>
著者
根本 純江 冨田 寛
出版者
日本口腔・咽頭科学会
雑誌
口腔・咽頭科 (ISSN:09175105)
巻号頁・発行日
vol.27, no.2, pp.165-172, 2014

心因性味覚障害とは, その患者が訴える味覚障害が, 味蕾の味覚受容機構の障害か, 神経伝達路における障害であるよりも, 心身症, 神経症, うつ, 人格障害等の心理的要素が強く関与し, 心療内科あるいは精神科の併用治療が必要と考えられる病態である. 先行研究では, 亜鉛欠乏性, 薬剤性, 全身疾患性等に比べて, 改善率や通院継続率が低いことが報告されている. 本研究は, 2011年~2012年の2年間に当院で診断, 治療した味覚障害340症例中, 心理面の関与が疑われた症例57例 (男性14例, 女性43例) について, 病態改善の向上を目的に, 管理栄養士との医療連携により, 心理療法 (認知行動療法, 簡易精神療法等) や栄養指導を実施した結果, 味覚検査における治癒, 有効を合わせた累積有効率, 通院継続率が向上したので報告する.
著者
若林 恭子 武藤 志真子 神戸 絹代 石川 元康
出版者
日本健康学会
雑誌
日本健康学会誌 (ISSN:24326712)
巻号頁・発行日
vol.84, no.1, pp.12-23, 2018

<p>The influence of stress on employee health has recently increased. The present study aims to clarify the relationship between eating behavior and stress as factors in obesity, which has become a central issue for lifestyle-related disease prevention. We surveyed 220 male employees between February and March 2014 and examined relationships among eight categories of eating behavior in four groups: obesity and high-stress (Group I), obesity and low-stress (Group II), non-obesity and high-stress (Group III) and non-obesity and low-stress (Group IV). We previously compared the scores for each category of four groups with those of a group with normal weight using t-tests. Here, we compared our earlier findings with those from the four groups described above. The responses showed that Groups I and III differed significantly in all categories related to eating behavior. This indicated that high stress was associated with changes in eating behavior and that some respondents had problems with eating behaviors regardless of whether they were obese. These results indicate that health guidance is needed in the future to understand the stress levels of obese individuals.</p>
著者
戸田郁子
雑誌
あたらしい眼科
巻号頁・発行日
vol.9, pp.1115-1120, 1992
被引用文献数
3
著者
榎戸 芙佐子 窪田 孝 中川 東夫 渡邉 健一郎 亀廣 摩弥 大原 聖子 地引 逸亀 野田 実希
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.46, no.10, pp.897-905, 2006
参考文献数
27

神経衰弱,慢性疲労症候群(CFS),うつ病の三者が疑われる3例の診断と治療・経過を紹介し,問題点を指摘し,今後の研究に対する提案を行った.症例1は疲労を主訴にインターネットの情報からCFSを疑って受診してきたがCFS疑診例であり,症状からICD-10の神経衰弱と診断し治療したが軽快に止まった.症例2もCFSを自己診断していたが,客観的所見に乏しく身体表現性障害と考えて治療していたとこう,妄想が明らかになり妄想性障害に診断を変更した.症例3は抑うつエピソード以前から身体徴候があり,リンパ節腫脹,関節痛,咽頭炎の症状からCFSと診断し,治療の結果ほぼ完治した.CFSと神経衰弱は社会的背景・症状が似ており,両者は文化的変異形と考えられる.れが国における神経衰弱の乱用ともいえる現状を考えると,CFSを積極的に診断し治療していくことが患者・家族の福利につながり,疲労の脳機能の解明にも貢献すると考えた.
著者
大越 俊夫
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.99, no.11, pp.891-896, 2006-11-01
参考文献数
15

Abnormal sensations in the throat can be induced by a wide variety of causes, and therefore requires both mental and physical approaches to treatment. In addition, malignant tumors maybe detected in a small number of patients with complaints of abnormal sensations in the throat, and this must never be overlooked. While there have been numerous reports descring various tests, diagnostic methods for determining the causes of abnormal sensations in the throat as well as administration the of therapeutic drugs vary among facilities and few reports have investigated cases of abnormal sensations refractory to initial treatment. Furthermore, although the involvement of psychogenesis in this illness is not small, the extent of its involvement is extremely difficult to assess. While therapeutic determination using various psychological tests and the effects of mild tranquilizers has been attempted, clarification of the extent of psychogenic involvement in this illness remains difficult, as does the treatment of this illness as a psychosomatic illness in the field of otolaryngology.<br>Improvement in abnormal sensations in the throat is determined by changes in the subjective symptoms of the patient. Many reports on the treatment of abnormal sensations in the throat have focused on the effects of administering a specific drug in response to a defined cause of illness, and few have reported the final improvement rates of the patients included in these studies. In other words, it is important to investigate secondary and tertiary treatment methods and the extent to which abnormal sensations in the throat has been improved in patients with abnormal sensations refractory to initial treatment, as well as the appropriate course of action when improvements are not observed.
著者
甲斐 智朗
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.95, no.7, pp.679-684, 2002-07-01
参考文献数
9
被引用文献数
2 1

Two cases of psychogenic hearing loss in adults are presented with the process of their mental states. Case 1 was a 20-year-old male who complained of unilateral hearing loss and tinnitus on his left side after receiving a &ldquo;karate&rdquo; kick on his left temple. Considering the perforation of his left tympanic membrane, his left hearing level was much worse (77.5 dBHL). Later examination of ABR revealed the sensorineural system to be intact, and functional hearing loss was suspected. Further questions about his history disclosed that he was extremely unhappy in his job and wanted to leave his present employment. After discussion with psychiatrists, the diagnosis of psychogenic hearing loss was established.<br>Case 2 was a 23-year-old male who complained of right tinnitus after hearing rifle shooting during night time maneuvers in the Self Defense Forces. In spite of the normal appearances of his external and middle ear, his hearing level was 72.5dBHL. Being treated as acoustic trauma, ABR was performed and it resulted in a completely normal response. In this case, the diagnosis of psychogenic hearing loss was also established.<br>Especially in adults, psychogenic hearing loss is regarded as a kind of conversion disorder. In this disease, getting ill brings some &ldquo;gain&rdquo; to the patients. Admission to the hospital separates a patient from his unpleasant job and persons (secondary gain). This is almost compatible with the mental state of case 1. When their desires are converted to physical disorders and are appreciated by another person, they don't have to be concerned by their source of annoyance. Thus their mental states are stabilized (primary gain). This is almost compatible with the mental state of case 2.<br>When assessing patients of Psychogenic hearing loss, their mental states should be considered as there may be various processes involved in the disease.
著者
小林雅文
雑誌
日歯心身
巻号頁・発行日
vol.9, pp.84-91, 1994
被引用文献数
2
著者
豊福 明
出版者
口腔病学会
雑誌
口腔病学会雑誌 (ISSN:03009149)
巻号頁・発行日
vol.74, no.3, pp.161-168, 2007-10-31
参考文献数
59
被引用文献数
3 1

1 0 0 0 OA 鉄道停車場

著者
竹内季一 著
出版者
鉄道時報局
巻号頁・発行日
vol.中編, 1916
著者
梅田 孝太
出版者
日本ミシェル・アンリ哲学会
雑誌
ミシェル・アンリ研究 (ISSN:21857873)
巻号頁・発行日
vol.10, pp.49-59, 2020 (Released:2020-06-28)
参考文献数
25

Philosophy can be understood as caring for the soul. In certain Greco–Roman traditions, the methods and doctrines of some schools of philosophy were considered to be therapeutic. For instance, this is acknowledged in texts on ancient medicine, especially those under the name of Hippocrates and also in the teachings of Epicurus. The understanding of philosophy as such was discussed by Nussbaum (1994) and Hadot (1995, 2002), and today the understanding of philosophy as therapeutic or as part of exercices spirituels is considered to shed light on the important role of philosophy. Although philosophy is commonly understood as a purely theoretical activity aimed at discovering truth, it is also widely understood as a part of care that helps us live a healthy and rational life. Hutter and Friedland (2013) and Faustino (2017) situate Nietzsche’s work in this tradition. Nietzsche referred to himself as a “psychologist” and repeatedly referred to his diagnoses of decadence and asceticism. However, as Werkhoven (2017) noted, the issues that Nietzsche diagnosed may be peculiar to modern people. Hutter (2013) does not explicitly treat of this gap; nevertheless, a certain distinction is needed between Nietzsche and the ancient exemplars of this tradition. Nietzsche’s own description of his therapy focuses on the affirmation of life. This approach assumes the modern understanding of life after the death of God. Here, what is life? What kind of therapy did Nietzsche suggest his suffering contemporaries? To pursue these themes, in this article, I revisit Michel Henry's interpretation of Nietzsche’s philosophy in relation to the phenomenology of life. In this context, I draw attention to the phenomenological dimension of Nietzsche’s therapy. I situate both in the tradition of philosophy as the therapy of life, which is an extension of the tradition of philosophical care, which has its origins in ancient times.

1 0 0 0 OA 官報

著者
大蔵省印刷局 [編]
出版者
日本マイクロ写真
巻号頁・発行日
vol.1938年06月14日, 1938-06-14