Psychosomatic Approach for Menopausal Women(<Special Issue>Clinical Management in Female Psychosomatic Disorders)

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  • 女性の更年期障害に対する心身医学的対応(<特集>女性をめぐる心身医学)
  • 女性の更年期障害に対する心身医学的対応
  • ジョセイ ノ コウネンキ ショウガイ ニ タイスル シンシン イガクテキ タイオウ

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Abstract

It is important to examine menopausal women from different angles. I usually diagnose them from psychosomatic medicine, mental diagnostic (DSM-IV), gynecological diagnostic and oriental (Kampo) medicine. We examined 2,166 cases of menopausal women who we treated in our clinic from 1995 to 2008. They can be sorted into four groups from a psychosomatic view, (1) somatic type (S-type, 1,001 patients, 46.2%), (2) depressive type (D-type, 640 patients, 29.5%), (3) neurotic type (N-type, 286 patients, 13.2%), (4) psychosomatic type (P-type, 239 patients, 11.0%). When they have been diagnosed by DSM-IV, there have been 1397 cases of somatoform disorders, 596 cases of mood disorders, 54 cases of panic disorders, 39 cases of anxiety disorders, 20 cases of sleep disorders, 9 cases of schizophrenia, 9 cases of adjustment disorders, 5 cases of sexual disorders, 4 cases of personality disorders, 3 cases of pain disorders, and 2 cases of eating disorders and 2 cases of conversion disorders. So we noticed that there were so many kind of levels of psychopathology. So we had to treat them individually. We had counseling to many patients who were sorted into P-type mainly, but to a few patients who were sorted into D and S-types. Many N and D-type patients were treated with tranquilizers and also D-type patients were treated with antidepressants. 1247 cases (57.6%) were treated by kampo therapy. 849 cases (39.2%) were treated by HRT. Prognoses were concerned with relationships to their husbands. We also show you a case of a menopausal woman who had a problem with her husband sexually. You can understand that she was D-type basically, and was S-type from her hormone state. Also, she was N-type from psychological tests and interviews. This case proves that menopausal disorder is one of the most typical psychosomatic disorder.

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