心身症と消化管

Psychosomatic Diseases in Gastroenterology

　精神身体医学，PSM（Psychosomatic medicine）の概念が日本に紹介されて，すでに十数年を経ている．

　心身症，PSD（Psychosomatic disease）とは，日本精神身体医学会の「心身症の治療指針」によれば，「身体症状を主とするが，その診断や治療に，心理的因子についての配慮がとくに重要な意味をもつ病態」とされていて，その立場から，心身症として，同じ治療指針では表1のような疾患あるいは症状を列挙している．これらの疾患をもつ患者のすべてが心身症というのではなく，その中のある患者は心身症としてアプローチすることが必要であるのだと理解されたい．

　A review of the literature of digestive disorders has been made that are treated of as psychosomatic diseases with a description of 4 illustrative cases encountered by us.

　Influence of emotion upon the digestive tract is set forth with a list of digestive tract disorders that are dealt with under psychosomatic diseases. Of these, reference has been made to gastric and duodenal ulcer, the so-called gastroptosis and chronic gastritis, anore-xia nervosa, irritable colon syndrome, postoperative abdominal neurosis, polysurgery, chronic pancreatitis, etc. Illustrated here are 2 cases of gastroduodenal ulcer caused by psychic stress, 1 of dysorexia nervosa and a case of suspected chronic pancreatitis. They are studied psychosomatically. We believe that psychosomatic treatment is a “must” because it is effective.

　In the treatment of above-mentioned disorders attention has been called to the care one must take in ascertaining the presence of any organic disease or that of psychosis.