Over the past decade, the main complaints of people with type 1 diabetes visiting the Department of Psychosomatic Medicine at Kyushu University Hospital have changed dramatically. Previously, the majority of patients with type 1 diabetes mellitus had concurrent eating disorders, with overeating and insulin omission. In recent years, however, the number of referrals with co-occurring eating disorders has decreased, and more patients are presenting with medically unexplained symptoms. Naturally, each person with type 1 diabetes mellitus has a different pathophysiology, and the treatment methods differ accordingly. The first half of this article introduces the concept of self-stigma and the three levels of psychosocial care for people with type 1 diabetes. In the second half of the paper, people with type 1 diabetes who have visited our department in recent years are divided into four types of patients according to their condition on a trial basis. We then discuss the treatment methods that may be effective and the role that the therapist should play.
"},{"@language":"ja","@value":"この10年間で，九州大学病院心療内科を受診する1型糖尿病をもつ人の主訴は大きく様変わりした．以前は，過食やインスリンオミッションを伴う摂食障害を併発した人が受診者の大半を占めていた．一方，近年では，摂食障害併発例の紹介は減り，器質的な異常を認めない身体症状が主訴の人が増えている．当然のことであるが，受診者それぞれに病態は異なり，それに応じて治療法も異なる．本稿の前半では，病態を考えるうえで知っておきたいセルフスティグマの概念，1型糖尿病をもつ人の状態に合わせた3段階の心理社会的ケアについて紹介する．後半では，近年当科を受診した1型糖尿病をもつ人を，試験的に病態別に4つのタイプに分けて，有効と思われる治療法および治療者が果たすべき役割について考察する．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410857593519204864","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Hata Tomokazu"},{"@language":"ja","@value":"波夛 伴和"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学病院心療内科"},{"@language":"en","@value":"Department of Psychosomatic Medicine, Kyushu University Hospital"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"03850307"},{"@type":"EISSN","@value":"21895996"}],"prism:publicationName":[{"@language":"ja","@value":"心身医学"},{"@language":"en","@value":"Japanese Journal of Psychosomatic Medicine"},{"@language":"ja","@value":"心身医"},{"@language":"en","@value":"Jpn J Psychosom Med"}],"dc:publisher":[{"@language":"en","@value":"Japanese Society of Psychosomatic Medicine"},{"@language":"ja","@value":"一般社団法人 日本心身医学会"}],"prism:publicationDate":"2023","prism:volume":"63","prism:number":"1","prism:startingPage":"27","prism:endingPage":"32"},"availableAt":"2023","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=1%E5%9E%8B%E7%B3%96%E5%B0%BF%E7%97%85","dc:title":"1型糖尿病"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%91%82%E9%A3%9F%E9%9A%9C%E5%AE%B3","dc:title":"摂食障害"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%82%B9%E3%83%86%E3%82%A3%E3%82%B0%E3%83%9E","dc:title":"スティグマ"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%82%A2%E3%83%89%E3%83%9C%E3%82%AB%E3%82%B7%E3%83%BC","dc:title":"アドボカシー"},{"@id":"https://cir.nii.ac.jp/all?q=type%201%20diabetes%20mellitus","dc:title":"type 1 diabetes mellitus"},{"@id":"https://cir.nii.ac.jp/all?q=eating%20disorder","dc:title":"eating disorder"},{"@id":"https://cir.nii.ac.jp/all?q=stigma","dc:title":"stigma"},{"@id":"https://cir.nii.ac.jp/all?q=advocacy","dc:title":"advocacy"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2010046601"}]}