How and when do middle-aged women learn about menopause?

＜Aim＞ We investigated the knowledge and image of menopause among middle aged women．＜Procedures＞ We administrated questionnaires to 76 outpatients with climacteric disorder and 49 healthy middle-aged women. The questionnaire consisted of items on demographics, questions about the knowledge and image of menopause, and the Scale of Menopause Knowledge（SMK）which we developed. ＜Results＞ The rates of women who responded they knew menopause well were 89.3 ％ in the patient group and 65.3 ％ in the healthy group respectively. Patients got the knowledge more through books, doctors and health care professionals than the healthy women did. The women who got the knowledge mainly when they were under thirties were more knowledgeable than those who got it mainly when they were over forty. The scores in the former group were higher than the later group in the subscales of “decrease of estrogen” and “health issues related to the aging process” in the SMK. Regarding images of menopause, few women had positive image. ＜Conclusion＞ Health education about menopause for women in their early life stage is required to deal with menopause

Fulfillment of the premenstrual dysphoric disorder criteria confirmed using a self-rating questionnaire among Japanese women with depressive disorders

<p>Abstract</p> <p>Background</p> <p>Some women with depressive disorders experience severe premenstrual symptoms. However, there have been few studies in which premenstrual symptoms in women suffering from depressive disorders were assessed. In this study, we aimed to investigate premenstrual symptoms in women with depressive disorders using the premenstrual dysphoric disorder (PMDD) scale.</p> <p>Methods</p> <p>We administered questionnaires to 65 Japanese female outpatients who had been diagnosed with a major depressive disorder or dysthymic disorder and to 303 healthy women as control subjects. The questionnaire consisted of items on demographics and the PMDD scale, which was modified from the premenstrual symptoms screening tool (PSST) developed by Steiner et al. (<it>Arch Womens Ment Health </it>2003, <b>6</b>:203-209).</p> <p>Results</p> <p>Twenty-eight women (43.1%) with depressive disorder fulfilled certain items of the PMDD scale. These women are considered to have coexisting PMDD and a depressive disorder, or to have premenstrual exacerbation (PME) of a depressive disorder. On the other hand, 18 women (5.9%) in the control group were diagnosed as having PMDD. The depressive disorder group who fulfilled the PMDD criteria had more knowledge of the term premenstrual syndrome (PMS) and took more actions to attenuate premenstrual symptoms than the control group with PMDD.</p> <p>Conclusions</p> <p>Our findings demonstrated that the occurrence of severe premenstrual symptoms is much higher in women with depressive disorders than in healthy subjects. This is partially due to this group containing women with PME, but mainly due to it containing women with PMDD. The higher percentage of PMDD suggests similarity between PMDD and other depressive disorders. Furthermore, educating healthy Japanese women and women with depressive disorders about premenstrual symptoms and evidence-based treatment for them is necessary.</p

コジン ドウテイ ニ カカワル 4ツ ノ コンニチテキ ココロミ

一人の個人を一人の個人と同定すること、即ち個人同定という概念は、古くから伝統的な法医学や古典的な犯罪学の中に育くまれてきた概念である。今日では、個人情報保護法として、個人を定める情報の保護という視点から、社会的に異なった視点から捉えられている。本稿においては、この個人同定の限界を探る自然科学における今日的な試みを紹介する。2つの日本学術振興会科研費を獲得して試行される4つの試みであり、既に一つは成果が上がりはじめている。この個人同定という概念は、人文科学的にみると仏教をはじめとする幾つかの宗教の奥義にある輪廻転生という思想に結びつく要素を孕んでおり、本稿に紹介する最後の研究は自然科学的なものでありながら、その要素に近づきつつあることを興味深く概観している

生体腎移植後の思春期レシピエントにおける遅延性適応障害

母をドナーとして生体腎移植を受けた後, 1～6年後に境界性人格障害状態を呈した4人の思春期レシピエントについての後方視的評価を報告する.精神医学的操作的診断基準を用いた場合,彼らは境界性人格障害と診断されるが,長期的経過と治療戦略から,遅延性適応障害との位置づけが適当であると考えた.精神症状の特徴は身体症状の優勢化,対人関係障害,衝動制御不全,情動不安定性,行動化,そして長期にわたる退行的入院である.転帰はおしなべて不良であった.1例は大量服薬の後肺炎で死亡し,他の2例は不安定な状態にある.透析に戻った1例のみが情緒的に安定した.精神症状の発現の基盤には,ドナー(母親)・レシピエント(子ども)間の共生関係と移植を受けた病院への依存,知的能力を含めた発達水準の問題などが指摘された.移植術前後にわたる,レシピエントのみならず,ドナーに対する長期的,定期的心理サポートシステムが必要とされる.この場合,移植病棟への長期入院は退行を引き起こすため回避されるべきである.Here we report a retrospective assessment of four adolescent recipients who developed borderline personality states between 1-6 years after receiving kidney transplants donated by their mothers. Even though such patients can be diagnosed as having borderline personality disorder using psychiatric operational diagnostic criteria, it is better to consider them as having adjustment disorders considering their long-term course and therapeutic strategy. The symptom characteristics included predominance of somatic symptoms, disturbance of inter-personal relationships, insufficient impulse control, emotional instability, acting-out and long-term regressive hospitalization. The outcome was invariably poor. One of the patients died of pneumonia after a massive self-inflicted drug overdose, and another two curently remain in an unstable condition. Only one patient is emotionally stable, although she has returned to dialysis. The basis of the psychiatric manifestation can be considered to be a symbiotic relationship between donor (mother) and recipient (child) and dependence on the hospital where the transplantation was carried out. The patients' developmental levels including intelligence are also discussed. Systems for regular long-term psychological support are needed not only for recipients but also for donors before and after transplantation. In such patients, long-term hospitalization in the transplantation ward must be avoided because it can cause regression of their mental state

高齢外来維持血液透析患者における認知障害に対する横断面的評価 : その予備的研究

認知機能低下の原因検索のために,高齢維持血液透析患者33人における気分の状態,生活の質,日常生活の活動性,身体的状態,社会動態学的因子,脳磁気共鳴映像法所見の関与について調査した. Mini Mental States Examinationの平均得点は26.06±4.13点であり,対象の18%に痴呆の可能性が示唆された.脳MRIにおいて,脳血管障害に関連した異常所見は対象の81%に認められた. World Health Organization Quality of Life assessmentにおける自己評価は認知機能低下に影響を受けていなかったが,痴呆が疑われる群は,非痴呆群に比べ,統計学的に明らかにヘマトクリット値が低く, Profile of Mood States得点が高かった.判別分析を用いたところ,ヘマトクリット平均値は認知障害の第一の予測因子であった.我々の所見から,多くの高齢透析患者における認知障害は治療可能であることが示唆される.原因ないし増悪因子となりうる要因は,貧血,抑うつ患者の偽性痴呆,孤立的環境における反応性の低下である.認知機能障害への貧血の影響は若い患者よりも高齢患者においてより深刻であると考えられる.本研究から高齢外来継持血液透析患者における認知機能低下については,その原因検索と診断に対し,多次元的なアプローチ施行の重要性が提案される.In order to establish the etiology of cognitive impairment, this study examined the contribution of mood states, quality of life, activities of daily living, physical condition, sociodemographic factors, and brain magnetic resonance imaging (MRI) findings in 33 elderly regular hemodialysis outpatients. The patients' mean (±SD) Mini Mental States Examination score was 26.06 ± 4.13. Of the entire cohort, 18% could potentially be diagnosed with dementia. Abnormal features and vascular damage in particular, were observed in the brain MRI of 81% of our subjects. Self-evaluation using the World Health Organization Quality of Life assessment appeared to be unaffected by cognitive impairment. However, the group with suspected dementia exhibited a significantly lower hematocrit and a significantly higher Profile of Mood States score than the non-dementia group. With the aid of discriminant function analysis, the mean hematocrit value was identified as the best predictor variables for cognitive impairment. Our findings suggest that the etiology of cognitive impairment in a lot of elderly hemodialysis patient is treatable. The most likely causative or aggravating factors appear to be anemia, pseudodementia of depressive patients, and decreased reactivity in an isolated environment. In addition, it may be that the influence of anemia on cognitive dysfunction is more serious in elderly patients than in the younger population. We propose that it is very important to impose a multidimensional approach on the diagnosis of the etiology of cognitive impairment