Skip to main content
Erschienen in: International Journal of Behavioral Medicine 5/2016

20.11.2015

Clinical Characteristics and Referral Patterns of Outpatients Visiting a Japanese Psychosomatic Medicine Clinic

verfasst von: Mutsuhiro Nakao, Takeaki Takeuchi

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

The definition of psychosomatic medicine is not consistent across countries.

Purpose

The study purpose was to clarify the applicability of the definition of psychosomatic illness issued by the Japanese Society of Psychosomatic Medicine to different types of referral in a university hospital.

Methods

The sample consisted of 1067 outpatients visiting a psychosomatic clinic. Participants completed questionnaires to assess degrees of somatization, depression, anxiety, and psychosocial stress after completing clinical interviews based on the Diagnostic and Statistical Manual, Fourth Edition, Text Revision. All subjects were classified into psychosomatic and non-psychosomatic groups, and the non-psychosomatic group was further divided into three additional groups: depression, anxiety, and other.

Results

In total, 398 (37 %) of the subjects were placed in the psychosomatic group. The percentage of the psychosomatic group was 46 % in those referred within the hospital, 37 % in those referred outside the hospital, and 28 % in those without referral from physicians. Concerning the non-psychosomatic group, 269 (25 %) were placed in the depression group, 229 (22 %) in the anxiety group, and 171 (16 %) in the other group. Membership in the psychosomatic group was positively associated with age and the severity of somatosensory amplification (both p < 0.05), but negatively associated with the severity of depression and anxiety as well as the classification of non-referral (all p < 0.05).

Conclusions

Although patients with psychiatric disorders, including depressive and anxiety disorders, are frequently seen in the Japanese psychosomatic clinic, patients who are diagnosed with psychosomatic illnesses tend to have been referred by physicians within the hospital. The concept of psychosomatic medicine needs to be further developed to assist both clinical practitioners and patients.
Literatur
1.
Zurück zum Zitat Leentjens AF, Rundell JR, Wolcott DL, Guthrie E, Kathol R, Diefenbacher A. Reprint of: Psychosomatic medicine and consultation–liaison psychiatry: scope of practice, processes, and competencies for psychiatrists working in the field of CL psychiatry or psychosomatics. A consensus statement of the European Association of Consultation–Liaison Psychiatry and Psychosomatics (EACLPP) and the Academy of Psychosomatic Medicine (APM). J Psychosom Res. 2011;70:486–91.CrossRefPubMed Leentjens AF, Rundell JR, Wolcott DL, Guthrie E, Kathol R, Diefenbacher A. Reprint of: Psychosomatic medicine and consultation–liaison psychiatry: scope of practice, processes, and competencies for psychiatrists working in the field of CL psychiatry or psychosomatics. A consensus statement of the European Association of Consultation–Liaison Psychiatry and Psychosomatics (EACLPP) and the Academy of Psychosomatic Medicine (APM). J Psychosom Res. 2011;70:486–91.CrossRefPubMed
2.
Zurück zum Zitat Fava GA, Belaise C, Sonino N. Psychosomatic medicine is a comprehensive field, not a synonym for consultation liaison psychiatry. Curr Psychiatry Rep. 2010;12:215–21.CrossRefPubMed Fava GA, Belaise C, Sonino N. Psychosomatic medicine is a comprehensive field, not a synonym for consultation liaison psychiatry. Curr Psychiatry Rep. 2010;12:215–21.CrossRefPubMed
4.
Zurück zum Zitat Sirri L, Fava GA. Diagnostic criteria for psychosomatic research and somatic symptom disorders. Int Rev Psychiatry. 2013;25:19–30.CrossRefPubMed Sirri L, Fava GA. Diagnostic criteria for psychosomatic research and somatic symptom disorders. Int Rev Psychiatry. 2013;25:19–30.CrossRefPubMed
5.
Zurück zum Zitat The Committee on Education and Training of the Japanese Society of Psychosomatic Medicine. An updated treatment guideline for psychosomatic medicine. Jpn J Psychosom Med. 1991;31:537–76 [in Japanese]. The Committee on Education and Training of the Japanese Society of Psychosomatic Medicine. An updated treatment guideline for psychosomatic medicine. Jpn J Psychosom Med. 1991;31:537–76 [in Japanese].
6.
Zurück zum Zitat American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Washington D.C: American Psychiatric Press; 2000.CrossRef American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Washington D.C: American Psychiatric Press; 2000.CrossRef
7.
Zurück zum Zitat Nakao M, Nomura S, Yamanaka G, Kumano H, Kuboki T. Assessment of patients by DSM-III-R and DSM-IV in a Japanese psychosomatic clinic. Psychother Psychosom. 1998;67:43–9.CrossRefPubMed Nakao M, Nomura S, Yamanaka G, Kumano H, Kuboki T. Assessment of patients by DSM-III-R and DSM-IV in a Japanese psychosomatic clinic. Psychother Psychosom. 1998;67:43–9.CrossRefPubMed
8.
9.
Zurück zum Zitat Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007;369:946–55.CrossRefPubMed Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007;369:946–55.CrossRefPubMed
10.
Zurück zum Zitat Huyse FJ, Herzog T, Lobo A, Malt UF, Opmeer BC, Stein B, et al. European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study. Psychosomatics. 2000;41:330–8.CrossRefPubMed Huyse FJ, Herzog T, Lobo A, Malt UF, Opmeer BC, Stein B, et al. European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study. Psychosomatics. 2000;41:330–8.CrossRefPubMed
11.
Zurück zum Zitat Deter HC. Psychosomatic medicine and psychotherapy: on the historical development of a special field in Germany. Adv Psychosom Med. 2004;26:181–9.CrossRefPubMed Deter HC. Psychosomatic medicine and psychotherapy: on the historical development of a special field in Germany. Adv Psychosom Med. 2004;26:181–9.CrossRefPubMed
12.
Zurück zum Zitat Novák M, Gazdag G, Túry F. Psychosomatic medicine and consultation–liaison psychiatry in Hungary. J Psychosom Res. 2009;66:187–8.CrossRefPubMed Novák M, Gazdag G, Túry F. Psychosomatic medicine and consultation–liaison psychiatry in Hungary. J Psychosom Res. 2009;66:187–8.CrossRefPubMed
13.
Zurück zum Zitat Nakao M, Takeuchi T, Yano E. Prescription of benzodiazepine in comparison with SSRI and SNRI for outpatients attending a Japanese university hospital. Int J Clin Pharmacol Ther. 2007;45:30–5.CrossRefPubMed Nakao M, Takeuchi T, Yano E. Prescription of benzodiazepine in comparison with SSRI and SNRI for outpatients attending a Japanese university hospital. Int J Clin Pharmacol Ther. 2007;45:30–5.CrossRefPubMed
14.
Zurück zum Zitat Nakao M, Takeuchi T, Fricchione GL. Definition of psychosomatic medicine and the applicability of DSM-IV-TR to outpatients visiting a Japanese psychosomatic clinic. Psychother Psychosom. 2014;83:120–1.CrossRefPubMed Nakao M, Takeuchi T, Fricchione GL. Definition of psychosomatic medicine and the applicability of DSM-IV-TR to outpatients visiting a Japanese psychosomatic clinic. Psychother Psychosom. 2014;83:120–1.CrossRefPubMed
15.
Zurück zum Zitat First MB, Spitzer RL, Gibbon M, Williams JBW. The structured clinical interview for DSM-IV axis I disorders, clinician version (SCID-CV). Washington D.C.: American Psychiatric Publishing, Inc; 1997. First MB, Spitzer RL, Gibbon M, Williams JBW. The structured clinical interview for DSM-IV axis I disorders, clinician version (SCID-CV). Washington D.C.: American Psychiatric Publishing, Inc; 1997.
16.
Zurück zum Zitat Nakao M, Kumano H, Nomura S, Kuboki T, Yokoyama K, Murata K. Fatigue mood as a discriminating indicator between anorexia nervosa and bulimia nervosa. Acta Psychiatr Scand. 1998;97:202–5.CrossRefPubMed Nakao M, Kumano H, Nomura S, Kuboki T, Yokoyama K, Murata K. Fatigue mood as a discriminating indicator between anorexia nervosa and bulimia nervosa. Acta Psychiatr Scand. 1998;97:202–5.CrossRefPubMed
17.
Zurück zum Zitat Nakao M, Kumano H, Nomura S, Kuboki T, Murata K. Assessment of ego state in anorexia nervosa and bulimia nervosa. Acta Psychiatr Scand. 1999;99:385–7.CrossRefPubMed Nakao M, Kumano H, Nomura S, Kuboki T, Murata K. Assessment of ego state in anorexia nervosa and bulimia nervosa. Acta Psychiatr Scand. 1999;99:385–7.CrossRefPubMed
19.
Zurück zum Zitat Cheng SK, Dizon J. Computerised cognitive behavioural therapy for insomnia: a systematic review and meta-analysis. Psychother Psychosom. 2012;81:206–16.CrossRefPubMed Cheng SK, Dizon J. Computerised cognitive behavioural therapy for insomnia: a systematic review and meta-analysis. Psychother Psychosom. 2012;81:206–16.CrossRefPubMed
21.
Zurück zum Zitat Kroenke K, Spitzer RL, Williams JB, Linzer M, Hahn SR, de Gruy 3rd FV, et al. Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment. Arch Fam Med. 1994;3:774–9.CrossRefPubMed Kroenke K, Spitzer RL, Williams JB, Linzer M, Hahn SR, de Gruy 3rd FV, et al. Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment. Arch Fam Med. 1994;3:774–9.CrossRefPubMed
22.
Zurück zum Zitat Kroenke K, Spitzer RL. Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med. 1998;60:150–5.CrossRefPubMed Kroenke K, Spitzer RL. Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med. 1998;60:150–5.CrossRefPubMed
23.
Zurück zum Zitat Nakao M, Fricchione G, Myers P, Zuttermeister PC, Baim M, Mandle CL, et al. Anxiety is a good indicator for somatic symptom reduction through a behavioral medicine intervention in a mind/body medicine clinic. Psychother Psychosom. 2001;70:50–7.CrossRefPubMed Nakao M, Fricchione G, Myers P, Zuttermeister PC, Baim M, Mandle CL, et al. Anxiety is a good indicator for somatic symptom reduction through a behavioral medicine intervention in a mind/body medicine clinic. Psychother Psychosom. 2001;70:50–7.CrossRefPubMed
24.
Zurück zum Zitat Nakao M, Myers P, Fricchione G, Zuttermeister PC, Barsky AJ, Benson H. Somatization and symptom reduction through a behavioral medicine intervention in a mind/body medicine clinic. Behav Med. 2001;26:169–76.CrossRefPubMed Nakao M, Myers P, Fricchione G, Zuttermeister PC, Barsky AJ, Benson H. Somatization and symptom reduction through a behavioral medicine intervention in a mind/body medicine clinic. Behav Med. 2001;26:169–76.CrossRefPubMed
25.
Zurück zum Zitat Barsky AJ, Wyshak G, Klerman GL. The somatosensory amplification scale and its relationship to hypochondriasis. J Psychiatr Res. 1990;24:323–34.CrossRefPubMed Barsky AJ, Wyshak G, Klerman GL. The somatosensory amplification scale and its relationship to hypochondriasis. J Psychiatr Res. 1990;24:323–34.CrossRefPubMed
26.
Zurück zum Zitat Nakao M, Kumano H, Kuboki T, Barsky AJ. Reliability and validity of the Japanese version of Somatosensory Amplification Scale: clinical application to psychosomatic illness. Jpn J Psychosom Med. 2001;41:539–47 [in Japanese]. Nakao M, Kumano H, Kuboki T, Barsky AJ. Reliability and validity of the Japanese version of Somatosensory Amplification Scale: clinical application to psychosomatic illness. Jpn J Psychosom Med. 2001;41:539–47 [in Japanese].
27.
Zurück zum Zitat Nakao M, Barsky AJ, Kumano H, Kuboki T. Relationship between somatosensory amplification and alexithymia in a Japanese psychosomatic clinic. Psychosomatics. 2002;43:55–60.CrossRefPubMed Nakao M, Barsky AJ, Kumano H, Kuboki T. Relationship between somatosensory amplification and alexithymia in a Japanese psychosomatic clinic. Psychosomatics. 2002;43:55–60.CrossRefPubMed
28.
Zurück zum Zitat McNair DM, Lorr M, Droppleman LF. Profile of mood states. Educational and industrial testing service. San Diego; 1971. McNair DM, Lorr M, Droppleman LF. Profile of mood states. Educational and industrial testing service. San Diego; 1971.
29.
Zurück zum Zitat Yokoyama K, Araki S, Kawakami N, Takeshita T. Production of the Japanese edition of Profile of Mood State (POMS): assessment of reliability and validity. Jpn J Public Health. 1990;37:913–8 [in Japanese]. Yokoyama K, Araki S, Kawakami N, Takeshita T. Production of the Japanese edition of Profile of Mood State (POMS): assessment of reliability and validity. Jpn J Public Health. 1990;37:913–8 [in Japanese].
30.
Zurück zum Zitat Nakao M, Shinozaki Y, Ahern DK, Barsky AJ. Anxiety as a predictor of improvements in somatic symptoms and health anxiety associated with cognitive–behavioral intervention in hypochondriasis. Psychother Psychosom. 2011;80:151–8.CrossRefPubMed Nakao M, Shinozaki Y, Ahern DK, Barsky AJ. Anxiety as a predictor of improvements in somatic symptoms and health anxiety associated with cognitive–behavioral intervention in hypochondriasis. Psychother Psychosom. 2011;80:151–8.CrossRefPubMed
31.
Zurück zum Zitat Nakao M, Yamanaka G, Kuboki T. Major depression and somatic symptoms in a mind/body medicine clinic. Psychopathology. 2001;34:230–5.CrossRefPubMed Nakao M, Yamanaka G, Kuboki T. Major depression and somatic symptoms in a mind/body medicine clinic. Psychopathology. 2001;34:230–5.CrossRefPubMed
32.
Zurück zum Zitat Nakao M, Yano E. Prediction of major depression in Japanese adults: somatic manifestation of depression in annual health examinations. J Affect Disord. 2006;90:29–35.CrossRefPubMed Nakao M, Yano E. Prediction of major depression in Japanese adults: somatic manifestation of depression in annual health examinations. J Affect Disord. 2006;90:29–35.CrossRefPubMed
33.
Zurück zum Zitat Ostergaard SD, Petrides G, Dinesen PT, Skadhede S, Bech P, Munk-Jørgensen P, et al. The association between physical morbidity and subtypes of severe depression. Psychother Psychosom. 2013;82:45–52.CrossRefPubMed Ostergaard SD, Petrides G, Dinesen PT, Skadhede S, Bech P, Munk-Jørgensen P, et al. The association between physical morbidity and subtypes of severe depression. Psychother Psychosom. 2013;82:45–52.CrossRefPubMed
34.
Zurück zum Zitat Gerrits MM, van Oppen P, van Marwijk HW, van der Horst H, Penninx BW. The impact of chronic somatic diseases on the course of depressive and anxiety disorders. Psychother Psychosom. 2013;82:64–6.CrossRefPubMed Gerrits MM, van Oppen P, van Marwijk HW, van der Horst H, Penninx BW. The impact of chronic somatic diseases on the course of depressive and anxiety disorders. Psychother Psychosom. 2013;82:64–6.CrossRefPubMed
35.
Zurück zum Zitat Fava GA, Trombini G, Grandi S, Bernardi M, Canestrari R. A psychosomatic outpatient clinic. Int J Psychiatry Med. 1987;17:261–7.CrossRefPubMed Fava GA, Trombini G, Grandi S, Bernardi M, Canestrari R. A psychosomatic outpatient clinic. Int J Psychiatry Med. 1987;17:261–7.CrossRefPubMed
36.
Zurück zum Zitat Wollburg E, Voigt K, Braukhaus C, Herzog A, Löwe B. Construct validity and descriptive validity of somatoform disorders in light of proposed changes for the DSM-5. J Psychosom Res. 2013;74:18–24.CrossRefPubMed Wollburg E, Voigt K, Braukhaus C, Herzog A, Löwe B. Construct validity and descriptive validity of somatoform disorders in light of proposed changes for the DSM-5. J Psychosom Res. 2013;74:18–24.CrossRefPubMed
37.
Zurück zum Zitat Voigt K, Wollburg E, Weinmann N, Herzog A, Meyer B, Langs G, et al. Predictive validity and clinical utility of DSM-5 Somatic Symptom Disorder: comparison with DSM-IV somatoform disorders and additional criteria for consideration. J Psychosom Res. 2012;73:345–50.CrossRefPubMed Voigt K, Wollburg E, Weinmann N, Herzog A, Meyer B, Langs G, et al. Predictive validity and clinical utility of DSM-5 Somatic Symptom Disorder: comparison with DSM-IV somatoform disorders and additional criteria for consideration. J Psychosom Res. 2012;73:345–50.CrossRefPubMed
38.
Zurück zum Zitat Sharma MP, Manjula M. Behavioural and psychological management of somatic symptom disorders: an overview. Int Rev Psychiatry. 2013;25:116–24.CrossRefPubMed Sharma MP, Manjula M. Behavioural and psychological management of somatic symptom disorders: an overview. Int Rev Psychiatry. 2013;25:116–24.CrossRefPubMed
39.
Zurück zum Zitat Rundell JR, Amundsen K, Rummans TL, Tennen G. Toward defining the scope of psychosomatic medicine practice: psychosomatic medicine in an outpatient, tertiary-care practice setting. Psychosomatics. 2008;49:487–93.CrossRefPubMed Rundell JR, Amundsen K, Rummans TL, Tennen G. Toward defining the scope of psychosomatic medicine practice: psychosomatic medicine in an outpatient, tertiary-care practice setting. Psychosomatics. 2008;49:487–93.CrossRefPubMed
Metadaten
Titel
Clinical Characteristics and Referral Patterns of Outpatients Visiting a Japanese Psychosomatic Medicine Clinic
verfasst von
Mutsuhiro Nakao
Takeaki Takeuchi
Publikationsdatum
20.11.2015
Verlag
Springer US
Erschienen in
International Journal of Behavioral Medicine / Ausgabe 5/2016
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-015-9520-0

Weitere Artikel der Ausgabe 5/2016

International Journal of Behavioral Medicine 5/2016 Zur Ausgabe