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Illness Behavior among Patients with Somatoform Disorders
Abstract- A 52-item Illness Behavior Questionnaire (IBQ) and 30-item General Health Questionnaire (GHQ-30) were administered to 43 somatoform disorders patients in psychiatric clinic, 40 chronic pain patients in pain clinic, and 38 somatoform disorders patients in Dalian medical school hospital. Responses of the three groups were scored on the seven scales of the IBQ measuring general hypochondoriasis, disease conviction, somatic versus psychological perception of illness, affective inhibition, affective disturbance, denial, and irritability. The significant differences between psychiatry and pain clinic were observed on the score of the GHQ-30 and somatic versus psychological perception of illness, affective disturbance, and denial of the IBQ. The significant differences of psychiatry clinic between Saga and Dalian in China were observed on the score of the GHQ-30 and the IBQ except somatic versus psychological perception of illness and denial. It indicated psychiatry clinic patients felt somehow responsible for the anxiety and/or depression and were in need of psychiatric help. However, pain clinic patients showed significantly high score of denial, indicating a denial of any psychological problems apart from the pain. On the other hand, Chinese patients have high level of psychological complaint. The common phenomenon was observed in somatic versus psychological perception of illness and denial. These results suggest that this response pattern may reflect whether patients with pain go to pain or psychiatry clinic as a form of illness behavior and the threshold of admission based on the socio-cultural background.
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£±) Katon W, Walker E: Medically unexplained symptoms in primary care. J Clin Psychiatry, Suppl 20:15-21, 1998. £²) Hartz A, Noyes R, Bentlers, et al.: Unexplained symptoms in primary care: perspectives of doctor and patients. Gen Hosp Psychiatry, 22:144-152, 2000. £³) Fink P, Sorensen L, Engberg M: Somatization in primary care: prevalence, health care utilization, and general practitioner recognition. Psychosomatics, 40:330-338, 1999. £´) Goldberg D, Rickels K, Drowning R, et al.: A comparison of two psychiatric screening test. Br J Psychiatry 129:61-69, 1976. £µ) Kitamura T, Sugawara M, Aoki M, et al.: Validity of the Japanese version of the GHQ among antenatal clinic attendants. Psychol Med 19:507-511, 1989. £¶) Sato T, Takeichi M: Lifetime prevalence of specific psychiatric disorders in a general medicine clinic. Gen Hosp Psychiatry, 15:224-233, 1993. £·) Pilowsky I, Spence N: Manual for the Illness Behavior Questionnaire (IBQ) Third Edition. University of Adelaide, Australia, 1994. £¸) Honda T, Toyokura M, Muratsu K, et al.: The Illness Behavior Questionnaire (IBQ): An investigation of the Japanese version. Pain Research 10:31-37, 1995. £¹) Pilowsky I, Spence N: Manual for the Illness Behavior Questionnaire (IBQ) Second Edtion. University of Adelaide, Australia, 1983. 10) Pilowsky I, Spence N: Illness haviour syndromes associated with intractable pain. Pain 2:61-71, 1976. 11) Pilowsky I, Spence N: Is illness behaviour related to chronicity in patients with intractable pain? Pain 2:167-173, 1976. 12) Chapman C, Sola A, Bonica J: Illness behavior and depression compared in pain center and private practice patients. Pain 6:1-7, 1979. 13) Skevington S: Activities as indices of illness behaviour in chronic pain. Pain 15:295-307, 1983. 14) Katon W, Von Korff M, Lin E, et al.: A randomized trial of psychiatric consultation with distressed high utilizers. Gen Hosp Psychiatry 14:86-98, 1992. 15) Sato T, Takeichi M, Shirahama M, et al.: Doctor-shopping patients and users of alternative medicine among Japanese primary care patients. Gen Hosp Psychiatry 17:115-125, 1995. 16) Sato T, Takeichi M, Hara T, et al.: Second opinion behaviour among Japanese primary care patients. Br J Gen Pract 49:546-550, 1999. 17)º´Æ£¡¡Éð¡§14¡¥µ¡Ç½Åª¤Ê¿ÈÂÎ½¥ÁÊ¤È¿ÈÂÎÉ½¸½À¾ã³²¡¥ÊÔÃø¡§Cassem NH ´ÆÌõ¡§¹õß·¡¡¾°¡¢ÊÝºä¡¡Î´¡§MGHÁí¹çÉÂ±¡Àº¿À°å³Ø¥Þ¥Ë¥å¥¢¥ë¡¥Åìµþ¡¤1999¡¤Medical Science International, 279-305. 18) Hosaka T, Sato T, Yamamoto K: Therapeutic models for somatoform disorders in liaison psychiatry. Int J Psychiatr Clin Pract 2:189-193, 1998. 19) Sato T, Guo Y, Takeichi M, Koizumi S: Effects of cooperative physician/ psychiatrist-oriented treatment on patients with somatoform disorders. Jpn Gen Hosp Psychiary 12:14-19, 2000.

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1) À¶¿å¿®¡¢³Þ¸¶ÍÎÍ¦¡¢ËÌÀ¾·ûÆó¡¢Â¾¡§Æâ²Ê¤òË¬¤ì¤ë¤¦¤ÄÉÂ´µ¼Ô¤Ë¤Ä¤¤¤Æ¡¥¿·Ê¡¾°Éð¶µ¼øÂà¿¦µÇ°ÏÀÊ¸½¸¡¥189¡Ý195¡¤1979. 2) Æ£°æ·°¡¢Æ»ÄÔ½Ó°ìÏº¡¢¹ÓÌÚ·û°ì¡§Æâ²Ê³°Íè¤Ë¤ª¤±¤ë¤¦¤ÄÉÂ¤ÎÉÑÅÙ¡¥¿´¿È°å³Ø 33:105-109,1993. 3) ÄÅÅÄ»Ê¡¢½ÅËÜ¹°Äê¡¢Ê¿Ìî´²¡¢Â¾¡§¥×¥é¥¤¥Þ¥ê¡¦¥±¥¢¤Ë¤ª¤±¤ë¤¦¤ÄÉÂ¤Î¸¡Æ¤¡¥ÆüËÜ°å»ö¿·Êó3117:47-50, 1984. 4) Sato T, Takeichi M: Lifetime prevalence of specific psychiatric disorders in a general medicine clinic. Gen Hosp Psychiatry 15:224-233, 1993. 5) Mino Y, Aoyama H, Froom J: Depressive disorders in Japanese primary care patients. Fam Pract 11:363-367, 1994. 6) Nishioka Y, Nishizono M, Yamamoto J: The distribution of mental illness found by DIS (Diagnostic Interview Schedule) among internal and orthopedic patients. Jpn J Psychiatr Neurol 44:33-54, 1990. 7) Nakane Y, Michitsuji S: Results from the Nagasaki Centre. Mental Illness in General Health Care: An International Study. Edited by TB Ustun and N Sartorius, John Wiley & Sons Ltd, pp.193-209, 1995. 8) Utsunomiya H, Yoshitake K, Otsuka T, Sugasakl H, Sata M, Hatada K, Nakane Y: Methodological issues of an epidemiological study: from the results of a study on psychological problems seen in outpatients visiting the internal medicine departments of general hospitals. Psychiatry Clin Neurosci 53:25-32, 1999. 9) Á°ÌîÅ¯Çî¡¢ÌÚß·µÁÇ·¡§Æ¬ÄË¡¦Á´¿È·ñÂÕ´¶¤Ç°ìÈÌ³°Íè¤ò¼õ¿Ç¤¹¤ë´µ¼Ô¤Ë¤ª¤±¤ë¤¦¤ÄÉÂ¤ÎÉÑÅÙ¡Ê²ñµÄÏ¿¡Ë¡¥ÆüËÜ¥×¥é¥¤¥Þ¥ê¡¦¥±¥¢³Ø²ñ»¨»ï22 suppl:86, 1999. 10) Sheehan DV, Lecrubier Y: M.I.N.I. Mini-International Neuropsychiatric Interview¡ÊÂçÄÚÅ·Ê¿¡¢µÜ²¬Åù¡¢¾åÅç¹ñÍø¡ÊÌõ¡Ë¡§Àº¿À¼À´µ´Ê°×¹½Â¤²½ÌÌÀÜË¡¡¢À±ÏÂ½ñÅ¹¡¢2000¡Ë 11) ÂçÄÚÅ·Ê¿¡¢ÅÄÃæ¹î½Ó¡¢¼ÄÅÄ½ß»Ò¡¢º´ÌîÆà¡¹¡¢µÜ²¬Åù¡¢¾åÅç¹ñÍø¡§Mini-International Neuropsychiatric Interview (M.I.N.I.)ÆüËÜ¸ìÈÇ¤Î¿®ÍêÀ¡¦ÂÅÅöÀ¸¡Æ¤¡¥Î×¾²Àº¿À°å³Ø¡ÊÅê¹ÆÃæ¡Ë¡¥ 12) Katon W, Walker EA: Medically unexplained symptoms in primary care. J Clin Psychiatry 59 Suppl. 20:15-21, 19998. 13) ¿ûºê¹°Ç·¡¢Ãæº¬°ôÊ¸¡¢±§ÅÔµÜ¹À¡¢º£Â¼Ë§Çî¡¢ÀÐºêÍµ¹á¡§¡Ö¥×¥é¥¤¥Þ¥ê¡¦¥±¥¢¤Ë¤ª¤±¤ëÀº¿À¼À´µ¤Î¿ÇÎÅ¥Ñ¥Ã¥±¡¼¥¸¡ÊWHOÈÇ¡Ë¡×¤ÎÍÍÑÀ¤Î¸¡Æ¤¤Ë´Ø¤¹¤ë¥×¥í¥¸¥§¥¯¥È¡¥Áí¹çÉÂ±¡Àº¿À°å³Ø 12:21-29, 2000.
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A comparative study of the prevalence of mental illnesses in general medicine settings between university hospital and general hospital - preliminary report

This study was designed to examine the prevalence of mental illnesses in general medicine settings between university hospital and general hospital and to compare them. The subjects of this study were 23 patients who visited the two hospitals for the first time respectively. Mini-International Neuropsychiatric Interview (M.I.N.I.) was conducted during the first visit in a random sample. The prevalence of psychiatric illnesses based on the M.I.N.I. was 43.5% in the university hospital and 34.8% in the general hospital. There was no significant difference of prevalence of mental illnesses between the two hospitals. The main differences found between the two hospitals were that university hospital had six patients with major depressive episode, while general hospital had three patients with alcohol dependence. We emphasize that the understanding and education of mental illnesses in primary care are essential.
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Fractal dimension analysis of physiological parameters – With special reference to NK cell activity and serum cortisol
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Fractal dimension analysis of physiological parameters – With special reference to NK cell activity and serum cortisol
The correlation between the immuno-endorinological function and fractal dimension of physiological parameters had not been investigated. The purpose of our study is to explore the relation between this function (NK cell activity and serum cortisol) and the fractal dimension of physiological data. Eighty-five medical students in Saga medical school were recruited. We measured the fractal dimensions of the EEG-Fz, -Cz, -Pz, the horizontal and vertical left eye movement, ECG, a plethysmogram of the finger, the thoracic and abdominal respiratory curves, and left EMG (the massetric muscle) in a relaxed state. The NK cell activity was measured using 51Cr free method. The serum cortisol was measured using RIA method. The fractal dimension of EMG has the statistical significant correlation with the serum cortisol positively (p<.005). The results of our study indicate that the complexity of muscle movement has an internal correlation with serum cortisol.

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