Kyushu University Academic Staff Educational and Research Activities Database
List of Papers
Masako Hosoi Last modified date:2023.12.06

Lecturer / Department of Psychosomatic Medicine, Graduate School of Medical Sciences / Psychosomatic Medicine / Kyushu University Hospital

1. Fibromyalgia (FM) is a disease characterized by chronic widespread pain concomitant with psychiatric symptoms such as anxiety and depression. It has been reported that FM patients engage in pain catastrophizing. In this study, we investigated characteristics of the brain volume of female FM patients and the association between psychological indices and brain volume. Thirty-nine female FM patients and 25 female healthy controls (HCs) were recruited for the study, and five FM patients were excluded due to white matter lesions. The following analyses were performed: (1) T1-weighted MRI were acquired for 34 FM patients (age 41.6 ± 7.4) and 25 HCs (age 39.5 ± 7.4). SPM12 was used to compare their gray and white matter volumes. (2) Data from anxiety and depression questionnaires (State-Trait Anxiety Inventory and Hospital Anxiety and Depression Scale), the Pain Catastrophizing Scale (subscales rumination, helplessness, magnification), and MRI were acquired for 34 FM patients (age 41.6 ± 7.4). Correlation analysis was done of the psychological indices and brain volume. We found that (1) The white matter volume of the temporal pole was larger in the FM patient group than in the HC group. (2) Correlation analysis of the psychological indices and gray matter volume showed a negative correlation between trait anxiety and the amygdala. For the white matter volume, positive correlations were found between depression and the brainstem and between magnification and the postcentral gyrus. Changes in the brain volume of female FM patients may be related to anxiety, depression, and pain catastrophizing..
2. Kimura, S., Hosoi, M., Otsuru, N., Iwasaki, M., Matsubara, T., Mizuno, Y., Nishihara, M., Murakami, T., Yamazaki, R., Ijiro, H., Anno, K., Watanabe, K., Kitamura, T. & Yamada, S, A novel exercise facilitation method in combination with cognitive behavioral therapy using the ikiiki rehabilitation notebook for intractable chronic pain: Technical report and 22 cases, Healthcare (Switzerland)Healthcare (Basel) , 10.3390/healthcare9091209, 9, 9, 1209-1209, PMID: 34574983 PMCID: PMC8467535, 2021.09.
3. Tomioka, M., Hosoi, M., Okuzawa, T., Anno, K., Iwaki, R., Kawata, H., Kubo, C. & Sudo, N., The effectiveness of Pictorial Representation of Illness and Self Measure (PRISM) for the assessment of the suffering and quality of interpersonal relationships of patients with chronic pain, BioPsychoSocial Medicine, doi: 10.1186/s13030-021-00223-0., 15, 1, PMID: 34801076, 2022.01.
4. Koji Fujimoto, Masako Hosoi, Ryoko Katsuki, Toshio Matsushima, Keitaro Matsuo, Tomohiro Nakao, Nobuyuki Sudo, Takahiro A. Kato, Psychological traits of patients with depression comorbid with chronic pain: Are Complaint and Competitive tendency related to pain?, Frontiers in Psychiatry, section Psychological Therapy and Psychosomatics, Manuscript ID: 825422, 2022.01.
5. Shunya Tanaka, Masahiro Ohgidani, Nobuhiro Hata, Shogo Inamine, Noriaki Sagata, Noritoshi Shirouzu, Nobutaka Mukae, Satoshi O.Suzuki, Hideomi Hamasaki, Ryusuke Hatae, Yuhei Sangatsuda, Yutaka Fujioka, Kosuke Takigawa, Yusuke Funakoshi, Toru Iwaki, Masako Hosoi, Koji Iihara, Masahiro Mizoguchi and Takahiro A.Kato, CD206 Expression in Induced Microglia-Like Cells From Peripheral Blood as a Surrogate Biomaeker for the Specific Immune Microenvironment of Neurosurgical Diseases Including Glioma, frontiers in Immunolo , 2021.06.
6. Mao Shibata, Tomoyuki Ohara, Masako Hosoi, Hata Jun, Daigo Yoshida, Naoki Hirabayashi, Yukiko Morisaki, Taro Nakazawa, Akane Mihara, Takuya Nagata, Emi Oishi, Kozo Anno, Nobuyuki Sudo, Toshiharu Ninomiya, Emotional loneliness is associated with a risk of dementia in a general Japanese older population: the Hisayama Study, The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 10.1093/geronb/gbaa196, 2020 Nov 10, gbaa196., 2020.11, [URL], Objectives: To investigate the association of loneliness and its component subscales with the risk of dementia in a general Japanese older population.

Method: A total of 1,141 community-dwelling Japanese residents aged ≥65 years without dementia were prospectively followed up for a median 5.0 years. We evaluated any loneliness and its component subscales-namely, social and emotional loneliness-by using the 6-Item de Jong Gierveld Loneliness Scale. Cox proportional hazards models were used to estimate hazard ratios (HRs) of each loneliness type on the risk of dementia controlling for demographic factors, lifestyle factors, physical factors, social isolation factors, and depression.

Results: During the follow-up, 114 participants developed dementia. The age- and sex-adjusted incidence rate of dementia was significantly greater in participants with any loneliness and emotional loneliness than those without. The multivariable-adjusted HRs (95% confidence intervals) of participants with any loneliness and emotional loneliness on incident dementia were 1.61 (1.08-2.40) and 1.65 (1.07-2.54), respectively, as compared to those without. However, there was no significant association between social loneliness and dementia risk. In subgroup analyses of social isolation factors, excess risks of dementia associated with emotional loneliness were observed in participants who had a partner, lived with someone, or rarely communicated with relatives or friends, but such association was not significant in participants who had no partner, lived alone, or frequently communicated with friends or relatives.

Discussion: The present study suggested that loneliness, especially emotional loneliness, was a significant risk factor for the development of dementia in the general older population in Japan.

Keywords: alienation; communication; epidemiology; prospective cohort study; social exclusion..
7. Shibata M, Ninomiya T, Anno K, Kawata H, Iwaki R, Sawamoto R, Kubo C, Kiyohara Y, Sudo N, Hosoi M., Parenting style during childhood is associated with the development of chronic pain and a patient's need for psychosomatic treatment in adulthood., Medicine 99 (29) 2020 7.17, p e21230, 2020.07.
8. Hidetoshi Tozaki-Saitoh, Izumi Sasaki, Tomohiro Yamashita, Masako Hosoi, Takahiro A. Kato, Makoto Tsuda, Involvement of exchange protein directly activated by cAMP and tumor progression locus 2 in IL-1β production in microglial cells following activation of β-adrenergic receptors, Journal of Pharmacological Sciences, 10.1016/j.jphs.2020.03.004, 2020.01, Endogenous noradrenaline (NA) has multiple bioactive functions and, in the central nervous system (CNS), has been implicated in modulating neuroinflammation via β-adrenergic receptors (β-ARs). Microglia, resident macrophages in the CNS, have a central role in the brain immune system and have been reported to be activated by NA. However, intracellular signaling mechanisms of the AR-mediated proinflammatory responses of microglia are not fully understood. Using a rapid and stable in vitro reporter assay system to evaluate IL-1β production in microglial BV2 cells, we found that NA and the β-AR agonist isoproterenol upregulated the IL-1β reporter activity. This effect was suppressed by β-AR antagonists. We further examined the involvement of EPAC (exchange protein directly activated by cAMP) and TPL2 (tumor progression locus 2, MAP3K8) and found that inhibitors for EPAC and TPL2 reduced AR agonist-induced IL-1β reporter activity. These inhibitors also suppressed NA-induced endogenous Il1b mRNA expression and IL-1β protein production. Our results suggest that EPAC and TPL2 are involved in β-AR-mediated IL-1β production in microglial cells, and extend our understanding of its intracellular signaling mechanism..
9. Ohgidani M, Kato TA, Hosoi M, Tsuda M, Hayakawa K, Hayaki C, Iwaki R, Sagata N, Hashimoto R, Inoue K, Sudo N, Kanba S, Fibromyalgia and microglial TNF-α: Translational research using human blood induced microglia-like cells, Scientific Reports, 10.1038/s41598-017-11506-4, 19;7(1):11882, 2017.09, [URL].
10. Tomoe Nishihara, Takehiro Nozaki, Ryoko Sawamoto, Gen Komaki, Noriyuki Miyata, Masako Hosoi, Nobuyuki Sudo, Effects of Weight Loss on Sweet Taste Preference and Palatability following Cognitive Behavioral Therapy for Women with Obesity., Obesity Facts, 10.1159/000502236, 12, 5, 529-542, 2019.09, Objective: Current evidence suggests that obesity is associated with alteration of sweet taste perception. The purpose of this study was to determine if nonsurgical cognitive behavioral therapy (CBT)-based weight loss can cause a change in sweet taste perception. Methods: This case-control study consisted of 51 women aged 21-64 years. Twenty-seven with obesity or overweight were assigned to an obesity (OB) group (BMI: 29.8 ± 0.5 kg/m2) and 24 to a normal control (NC) group (BMI: 20.9 ± 0.3 kg/m2). The OB group underwent a 30-week weight loss intervention using CBT-based group therapy. The results of measurement of detection threshold, suprathreshold perceived intensity, preference, and palatability, elements of sweet taste perception, were compared before and after the intervention. Psychological variables and appetite-related hormonal levels were measured. Results: Twenty-three patients and 22 controls completed the study. The OB group showed a 14.6% weight loss after the intervention. At baseline, the OB group preferred significantly higher sucrose concentrations than did the NC group; however, this difference was no longer significant after intervention. In the OB group, persistent pleasure and reduced desire for other taste, measured by repeated exposure to sweetness, normalized after weight loss to levels comparable to those seen in the NC group. No significant difference in discriminative perception of the threshold concentration or the suprathreshold sensory value was found between the two groups before or after intervention. A significant correlation was found between the basal preferred sucrose concentration and the serum leptin level of the OB group after adjusting for confounding factors, such as BMI, depressive symptom score, and trait-anxiety scores. Conclusions: Weight loss induced by CBT-based nonsurgical intervention resulted in the normalization of the sucrose preference and palatability of women with obesity. Leptin activity may be associated with the altered sweet taste preference of people with obesity..
11. Valentina Tesio, Katharina S. Goerlich, Masako Hosoi, Lorys Castelli, Editorial
Alexithymia: State of the art and controversies. Clinical and neuroscientific evidence, Frontiers in Psychology, 10.3389/fpsyg.2019.01209, 10, MAY, 2019.01.
12. Kato, T, Ohgidani M, Hosoi, M et al., Translational Research Using Human Blood Directly Induced Microglia-Like (iMG) Cells; Over Gene Expression and Production of TNF-alpha After ATP Stimulation in iMG Cells from Patients with Fibromyalgia
and Cognitive-Neuroscience-Society, 56th Annual Meeting of the American-College-of-Neuropsychopharmacology (ACNP) 開催地: Palm Springs, CA 日付: DEC 03-07, 2017 Amer Coll Neuropsychopharmacol; Cognit Neuroscience Soc NEUROPSYCHOPHARMACOLOGY, 42, 補足: 1, S619-S619, 巻: 42 補足: 1 ページ: S619-S619 会議抄録: W227 発行: NOV 2017, 2017.11.
13. Chie Hayaki, Kozo Anno, Mao Shibata, Rie Iwaki, Hiroshi Kawata, Nobuyuki Sudo, Masako Hosoi, Family dysfunction A comparison of chronic widespread pain and chronic localized pain, MEDICINE, 10.1097/MD.0000000000005495, 95, 49, 2016.12.
14. Shibata M, Ninomiya T, Anno K, Kawata H, Iwaki R, Sawamoto R, Kubo C, Kiyohara Y, Sudo N, Hosoi M, Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study, BMC PSYCHIATRY, 10.1186/s12888-016-0926-2, 16, 2016.07.
15. Takahiro Ushida, Masahiko Shibata, Masaki Kitahara, Shoji Yabuki, Masahiko Sumitani, Takanori Murakami, Masako Iseki, Masako Hosoi, Hiroaki Shiokawa, Tomoko Tetsunaga, Hiroyuki Nishie, Sei Fukui, Motohiro Kawasaki, Sinsuke Inoue, Makoto Nishihara, Shuichi Aono, Tatunori Ikemoto, Takashi Kawai, Young Chang Arai, The effect of guidance regarding home exercise and ADL on adolescent females suffering from adverse effects after HPV vaccination in Japanese multidisciplinary pain centers, Pain Research and Management, 10.1155/2016/3689352, 2016, 2016.01, Background: Two prophylactic papillomavirus (HPV) vaccines have been available for primary prevention of cervical cancer. Although serious adverse effects (AE) were rare, more than 230 women have been suffering from severe AEs such as persistent pain and headache in Japan. Our research group started to treat adolescent females suffering from the AEs. Objective: To survey the characteristics of and the effects of cognitive behavioral therapy on adolescent female suffering from the AEs in Japanese multidisciplinary pain centers. Methods: One hundred and forty-five patients suffering from the AEs were reviewed retrospectively and 105 patients of them were provided guidance on home exercise and activities of daily living based partially on a cognitivebehavioral approach. The intensity of pain was rated by the patients using a numerical rating scale (NRS). Furthermore, the Hospital Anxiety and Depression Scale (HADS) and the Pain Catastrophizing Scale (PCS) were used. Results: Eighty out of the 105 patients who received the guidance were followed up, 10 displayed a marked improvement, and 43 showed some improvement. Conclusions: Guidance on home exercise and activities of daily living based on a cognitive-behavioral approach alleviated the AEs that women suffered from after HPV vaccination in Japan..
16. Ushida T, Shibata M, Kitahara M, Yabuki S, Sumitani M, Murakami T, Iseki M, Hosoi M, Hiroaki S, Tetsunaga T, Nishie H, Fukui S, Kawasaki M, Inoue S, Nishihara M, Aono S, Ikemoto T, Kawai T, Arai YC, The effect of guidance for home exercise and activities of daily living on female adolescents experiencing adverse events after human papillomavirus vaccination in Japanese multidisciplinary pain centres., Pain Res Manag, 2015.10.
17. Anno K, Shibata M, Ninomiya T, Iwaki R, Kawata H, Sawamoto R, Kubo C, Kiyohara Y, Sudo N, Hosoi M, Paternal and maternal bonding styles in childhood are associated with the prevalence of chronic pain in a general adult population: the Hisayama Study, BMC PSYCHIATRY, 10.1186/s12888-015-0574-y, 15, 2015.07.
18. Shibata M, Ninomiya T, Jensen MP, Anno K, Yonemoto K, Makino S, Iwaki R, Yamashiro K, Yoshida T, Imada Y, Kubo C, Kiyohara Y, Hosoi M, Sudo N, Alexithymia is Associated with Greater Risk of Chronic Pain and Negative Affect and with Lower Life Satisfaction in a General Population: The Hisayama Study, PLOS ONE, 10.1371/journal.pone.0090984, 9, 3, 2014.03.
19. Ritsuko Okamoto, Yoshinori Itoh, Yusuke Murata, Daisuke Kobayashi, Masako Hosoi, Kazunori Mine, Reduction of group II metabotropic glutamate receptors during development of benzodiazepine dependence, Pharmacology, 10.1159/000346440, 91, 3-4, 145-152, 2013.05, Prolonged use of benzodiazepines often leads to dependence and withdrawal syndrome. However, the cellular mechanisms underlying benzodiazepine dependence have not been fully clarified. Several investigators have shown an involvement of metabotropic glutamate receptors (mGluRs) in the pathophysiology of dependence or withdrawal. This study was performed to elucidate the role of mGluRs in benzodiazepine dependence. Withdrawal signs were precipitated in mice by flumazenil injection (25 mg/kg) after continuous subcutaneous infusion of benzodiazepines for 7 days, and the effects of several Gi-coupled receptor ligands on forskolin-stimulated cyclic AMP accumulation were examined in the cerebral cortex of mice. The mRNA expression for mGluRs was determined by RT-PCR. A single injection of flumazenil precipitated typical withdrawal signs such as tail elevation and tremor in mice treated with diazepam or alprazolam, but not quazepam. The inhibitory effect of nonselective mGluR ligands on adenylate cyclase activity was diminished in mice that showed signs of benzodiazepine withdrawal. The mRNA expression levels of mGluR2 and mGluR3 were lowered in the cerebral cortex of mice pretreated with diazepam or alprazolam. Our findings suggest that the reduction in the expression of group II mGluRs subunits may be involved in the development of benzodiazepine dependence..
20. Makino Seiko, Jensen Mark P., Arimura Tatsuyuki, Obata Tetsuji, Anno Kozo, Iwaki Rie, Kubo Chiharu, SUDO Nobuyuki, Hosoi Masako, Alexithymia and Chronic Pain The Role of Negative Affectivity, The Clinical Journal of Pain, 10.1097/AJP.0b013e3182579c63, 29, 4, 354-361, 2013.04.
21. Toshiyuki Yoshida, Ivan R. Molton, Mark P. Jensen, Tomoyasu Nakamura, Tatsuyuki Arimura, Chiharu Kubo, Masako Hosoi, Cognitions, metacognitions, and chronic pain, Rehabilitation Psychology, 10.1037/a0028903, 57, 3, 207-213, 2012.08, Purpose: Although the content of thoughts has received a considerable amount of attention in pain research, the importance of thought processes (metacognitions) has received less attention. Method: One hundred twenty-nine individuals with muscular dystrophy and chronic pain completed measures assessing metacognitions and frequency of both catastrophizing and pain control beliefs. Results: Greater use of reappraisal and distraction metacognitions were associated with more perceived control over pain, whereas greater use of worry and punishment metacognitions were associated with more catastrophizing. Conclusions/Implications: The current findings indicate that metacognitions are associated with both pain control beliefs and catastrophizing and therefore may play an important role in the development or maintenance of pain-related cognitive content thought to influence patient functioning. Research is needed to determine whether treatments that encourage changes in both metacognitions and cognitive content are more effective than treatments that focus on cognitive content alone..
22. Rie Iwaki, Tatsuyuki Arimura, Mark P. Jensen, Tomoyasu Nakamura, Koji Yamashiro, Seiko Makino, Tetsuji Obata, Nobuyuki Sudo, Chiharu Kubo, Masako Hosoi, Global Catastrophizing vs Catastrophizing Subdomains
Assessment and Associations with Patient Functioning, Pain Medicine (United States), 10.1111/j.1526-4637.2012.01353.x, 13, 5, 677-687, 2012.05, Objective. The primary objectives of the current study were to 1) confirm the three-factor model of the Pain Catastrophizing Scale (PCS) items in a Japanese sample and 2) identify the catastrophizing subdomain(s) most closely associated with measures of pain and functioning in a sample of individuals with chronic pain. Design. This was based on a cross-sectional observational study. Setting. This study was conducted in a university-based clinic. Patients. One hundred and sixty outpatients with chronic pain participated in this study. Outcome Measures. Patients completed the PCS, the Brief Pain Inventory, and the Hospital Anxiety and Depression Scale; 30 patients completed the PCS again between 1 and 4 weeks later. Results. Confirmatory factor analysis supported a three-factor structure of the Japanese version of the PCS, and univariate and multivariate associations with validity criterion supported the validity of the measure. Catastrophic helplessness was shown to make a unique contribution to the prediction of pain intensity, pain interference and depression, and catastrophic magnification made a unique contribution to the prediction of anxiety. Conclusions. The findings support the cross-cultural generalizability of the three-factor structure of the PCS and indicate that the PCS-assessed catastrophizing subdomains provide greater explanatory power than the PCS total score for understanding pain-related functioning. Wiley Periodicals, Inc..
23. Tatsuyuki Arimura, Masako Hosoi, Yoshihiro Tsukiyama, Toshiyuki Yoshida, Daiki Fujiwara, Masanori Tanaka, Ryuichi Tamura, Yasunori Nakashima, Nobuyuki Sudo, Chiharu Kubo, Pain Questionnaire Development Focusing on Cross-Cultural Equivalence to the Original Questionnaire
The Japanese Version of the Short-Form McGill Pain Questionnaire, Pain Medicine, 10.1111/j.1526-4637.2012.01333.x, 13, 4, 541-551, 2012.04, Objectives. The present study aimed to develop a Japanese version of the Short-Form McGill Pain Questionnaire (SF-MPQ-J) that focuses on cross-culturally equivalence to the original English version and to test its reliability and validity. Design. Cross-sectional design. Method. In study 1, SF-MPQ was translated and adapted into Japanese. It included construction of response scales equivalent to the original using a variation of the Thurstone method of equal-appearing intervals. A total of 147 undergraduate students and 44 pain patients participated in the development of the Japanese response scales. To measure the equivalence of pain descriptors, 62 pain patients in four diagnostic groups were asked to choose pain descriptors that described their pain. In study 2, chronic pain patients (N=126) completed the SF-MPQ-J, the Long-Form McGill Pain Questionnaire Japanese version (LF-MPQ-J), and the 11-point numerical rating scale of pain intensity. Correlation analysis examined the construct validity of the SF-MPQ-J. Results. The results from study 1 were used to develop SF-MPQ-J, which is linguistically equivalent to the original questionnaire. Response scales from SF-MPQ-J represented the original scale values. All pain descriptors, except one, were used by >33% in at least one of the four diagnostic groups. Study 2 exhibited adequate internal consistency and test-retest reliability, with the construct validity of SF-MPQ-J comparable to the original. Conclusion. These findings suggested that SF-MPQ-J is reliable, valid, and cross-culturally equivalent to the original questionnaire. Researchers might consider using this scale in multicenter, multi-ethnical trials or cross-cultural studies that include Japanese-speaking patients. Wiley Periodicals, Inc...
24. Koji Yamashiro, Tatsuyuki Arimura, Rie Iwaki, Mark P. Jensen, Chiharu Kubo, Masako Hosoi, A multidimensional measure of pain interference
Reliability and validity of the pain disability assessment scale, Clinical Journal of Pain, 10.1097/AJP.0b013e318204858a, 27, 4, 338-343, 2011.05, Objective: Measuring outcomes across multiple domains is essential for an adequate understanding of chronic pain and the effects of pain treatment. Pain interference reflects the negative effects of pain on functioning, and is recognized as a critical outcome domain. The Pain Disability Assessment Scale (PDAS) contains items that assess the negative effects of pain on broad spectrum pain interference domains. The purpose of this study was to examine the factor structure, reliability, and validity of the PDAS. Methods: One hundred sixty-four Japanese patients with chronic pain were administered the PDAS, the Brief Pain Inventory, and the Hospital Anxiety and Depression Scale. Results: The findings support a 3 factor structure of the PDAS items, as well as a high level of internal consistency of the scales created from these factors (Cronbach αs range: 0.87 to 0.95). Validity of the 3 scales was supported through their significant associations, in hypothesized directions, with measures of pain intensity, anxiety, depression, and another established measure of pain interference, as well as differences in PDAS scores between patients with versus without back pain. Conclusions: The PDAS may be useful when researchers or clinicians require a multidimensional measure of the effects of pain on a patients life..
25. Masako Hosoi, Ivan R. Molton, Mark P. Jensen, Dawn M. Ehde, Silvia Amtmann, Sarah O'Brien, Tatsuyuki Arimura, Chiharu Kubo, Relationships among alexithymia and pain intensity, pain interference, and vitality in persons with neuromuscular disease
Considering the effect of negative affectivity, Pain, 10.1016/j.pain.2010.02.012, 149, 2, 273-277, 2010.05, Alexithymia, the inability to identify or label emotions, has been shown to be associated with pain in patients with a number of chronic pain conditions. We sought to: (1) replicate this association in samples of persons with chronic pain secondary to neuromuscular disease, (2) extend this finding to other important pain-related measures, and (3) to determine whether relationships among alexithymia and study variables existed after controlling for negative affect. One hundred and twenty-nine individuals with muscular dystrophy and chronic pain were administered measures of alexithymia (Toronto Alexithymia Scale, TAS-20), pain intensity (0-10 NRS), pain interference (Brief Pain Inventory Interference scale), mental health (SF-36 Mental Health scale; as a proxy measure of negative affect) and vitality (SF-36 Vitality scale). Higher TAS scores were associated significantly with higher pain intensity and interference, and less vitality. Although the strengths of these associations were reduced when mental health was used as a control, the associations between the Difficulty Identifying Feelings scale and vitality, and the Externally Oriented Thinking and Total TAS scales and pain intensity remained statistically significant. The findings replicate and extend previous findings concerning the associations between alexithymia and important pain-related variables in a sample of persons with chronic pain and neuromuscular disease. Future research is needed to determine the extent to which the associations are due to (1) a possible causal effect of alexithymia on patient functioning that is mediated via its effects on negative affect or (2) the possibility that alexithymia/outcome relationships reflect response bias caused by general negative affectivity..
26. Seiko Funakoshi, Masako Hosoi, Osamu Tsuchida, [Psychosomatic medicine for non-cardiac chest pain]., Nippon rinsho. Japanese journal of clinical medicine, 67, 9, 1796-1802, 2009.01, Recently, it has become problematic that the number of noncardiac chest pain (NCCP) patients are increasing among those who come to the emergency room with chest pain as a chief complaint. They tend to come to hospitals often and over many years, even after cardiac-chest pain has been excluded from their diagnosis. Moreover, studies have shown that NCCP patients have a high prevalence of anxiety, depression and disability. However, most NCCP patients are usually treated by cardiologists or primary physicians. Ordinary biomedical approaches often fail to treat NCCP. NCCP is one of the most important functional somatic syndromes from the view of medical economics. The cause of NCCP includes gastroesophageal reflux disease, panic disorder and esophageal dysmotility. In this review article, we summarize the definition, epidemiology, pathology, and process of diagnosis of NCCP. Finally, we propose a pathological hypothesis from a psychosomatic view. We discuss the effects of anxiety, fear and hyperactive behavior induced by affective stressors on the dysmotility and the lowering of the pain threshold..
27. Masanori Handa, Hideyuki Nukina, Masako Hosoi, Chiharu Kubo, Childhood physical abuse in outpatients with psychosomatic symptoms, BioPsychoSocial Medicine, 10.1186/1751-0759-2-8, 2, 2008.03, Background: In Japan and Asia, few studies have been done of physical and sexual abuse. This study was aimed to determine whether a history of childhood physical abuse is associated with anxiety, depression and self-injurious behavior in outpatients with psychosomatic symptoms. Methods: We divided 564 consecutive new outpatients at the Department of Psychosomatic Medicine of Kyushu University Hospital into two groups: a physically abused group and a non-abused group. Psychological test scores and the prevalence of self-injurious behavior were compared between the two groups. Results: A history of childhood physical abuse was reported by patients with depressive disorders(12.7%), anxiety disorders(16.7%), eating disorders (16.3%), pain disorders (10.8%), irritable bowel syndrome (12.5%), and functional dyspepsia(7.5%). In both the patients with depressive disorders and those with anxiety disorders, STAI-I (state anxiety) and STAI-II (trait anxiety) were higher in the abused group than in the non-abused group (p
28. Misuzu Tanaka, Daisuke Kobayashi, Yuko Murakami, Norio Ozaki, Tatsuyo Suzuki, Nakao Iwata, Koichi Haraguchi, Ichiro Ieiri, Naoko Kinukawa, Masako Hosoi, Hisakazu Ohtani, Yasufumi Sawada, Kazunori Mine, Genetic polymorphisms in the 5-hydroxytryptamine type 3B receptor gene and paroxetine-induced nausea, International Journal of Neuropsychopharmacology, 10.1017/S1461145707007985, 11, 2, 261-267, 2008.03, Selective serotonin reuptake inhibitor (SSRI)-induced nausea can be severe enough to lead to early treatment discontinuation. However, it is currently not possible to predict the occurrence of nausea before the initiation of SSRI treatment. In this study, we investigated the effect of genetic polymorphisms in the 5-hydroxytryptamine type 2A, 3A, and 3B (5-HT3B) receptors, 5-HT transporter, and CYP2D6 genes on the incidence of paroxetine-induced nausea. A consecutive series of 72 Japanese patients with depressive or anxiety disorders were treated with paroxetine. Paroxetine-induced nausea was assessed by a pharmacist and was observed in 29.2% of the patients. A significant (nominal p=0.00286) association was found between the incidence of nausea and the -100_-102AAG insertion/deletion polymorphism of the 5-HT3B receptor gene. No significant associations were observed between the other genetic polymorphisms and the incidence of nausea. The -100_-102AAG deletion variant of the 5-HT3B receptor gene may a.ect paroxetine-induced nausea..
29. Wei Xiong, Masako Hosoi, Bon Nyeo Koo, Li Zhang, Anandamide inhibition of 5-HT3A receptors varies with receptor density and desensitization, Molecular Pharmacology, 10.1124/mol.107.039149, 73, 2, 314-322, 2008.02, Converging evidence has suggested that anandamide (AEA), an endogenous agonist of cannabinoid (CB) receptors, can directly interact with certain types of ligand-gated ion channels (LGICs). However, little is known about the molecular and cellular mechanisms of AEA-induced direct effects on LGICs. Here, we report that AEA inhibited the function of serotonin-gated ion channels (5-HT3A) expressed in Xenopus laevis oocytes and human embryonic kidney 293 cells in a manner that was dependent on the steady-state receptor density at the cell surface. The magnitude of AEA inhibition was inversely correlated with the expression levels of receptor protein and function. With increasing surface receptor expression, the magnitude of AEA inhibition decreased. Consistent with this idea, pretreatment with actinomycin D, which inhibits transcription, decreased the amplitude of current activated by maximal concentrations of 5-hydroxytryptamine (5-HT) and increased the magnitude of AEA inhibition. AEA did not significantly alter 5-HT3A receptor trafficking. However, AEA accelerated 5-HT3A receptor desensitization time in a concentration-dependent manner without significantly changing receptor activation and deactivation time. The desensitization time was correlated with the AEA-induced inhibiting effect and mean 5-HT current density. Applications of 5-hydroxyindole and nocodazole, a microtubule disruptor, significantly slowed 5-HT3A receptor desensitization and reduced the magnitude of AEA inhibition. These observations suggest that 5-HT3 receptor density at the steady state regulates receptor desensitization kinetics and the potency of AEA-induced inhibiting effect on the receptors. The inhibition of 5-HT3 receptors by AEA may contribute to its physiological roles in control of pain and emesis..
30. Shinichi Tsutsui, Kazunori Mine, Masanori Handa, Haruo Hayashi, Masako Hosoi, Naoko Kinukawa, Chiharu Kubo, Edrophonium provocative testing for the evaluation of upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia, Digestive Diseases and Sciences, 10.1007/s10620-005-9063-3, 51, 8, 1302-1306, 2006.08, The aim of this study was to examine if edrophonium provocative testing is useful for evaluating upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia (NUD). A questionnaire rating dyspeptic symptoms was done for 58 patients with NUD. The patients were then given an intravenous infusion of saline followed by 5 mg of edrophonium. Baseline esophageal manometry was also done. Patients whose usual symptoms were reproduced (48.3%) had significantly higher symptom scores (13.0 [8.5, 17.0] vs. 8.5 [6.0, 11.0]; P = 0.015) and a significantly higher number of symptoms (4.0 [2.5, 6.0] vs. 3.0 [1.0, 4.0]; P = 0.010) than patients whose usual symptoms were not reproduced. The presence of an esophageal motility disorder was not significantly different between the two groups. These findings suggest upper gastrointestinal hypersensitivity in the patients whose symptoms were reproduced. Edrophonium provocative testing might be useful for evaluating upper gastrointestinal hypersensitivity in patients with NUD..
31. Ye J, Li Y, Teruya K, Katakura Y, Ichikawa A, Eto H, Hosoi M, Hosoi M, Nishimoto S, Shirahata S., Enzyme-digested Fucoidan Extracts Derived from Seaweed Mozuku of Cladosiphon novae-caledoniae kylin Inhibit Invasion and Angiogenesis of Tumor Cells, Cytotechnology. , 10.1007/s10616-005-3761-8, 47, 1-3, 117-126, Cytotechnology. 2005 Jan;47(1-3):117-26., 2005.01.
32. Hayashi H, Mine K, Hosoi M, Tsuchida O, Handa M, Kinukawa N, Andou K, Kubo C, Comparison of the esophageal manometric characteristics of idiopathic and reflux-associated esophageal spasm: evaluation by 24-hour ambulatory esophageal motility and pH monitoring., Digestive Diseases and Sciences, 10.1023/B:DDAS.0000004514.91064.7f, 48, 11, 2124-2131, 48 (11) : 2124-2131, 2003.11.
33. Yoshio Kanemitsu, Masako Hosoi, Ping Jun Zhu, Forrest F. Weight, Robert W. Peoples, Joseph S. McLaughlin, Li Zhang, Dynorphin A inhibits NMDA receptors through a pH-dependent mechanism, Molecular and Cellular Neuroscience, 10.1016/S1044-7431(03)00214-8, 24, 3, 525-537, 2003.01, Dynorphin A (DynA), an endogenous agonist of κ-opioid receptors, has also been reported to directly interact with the NMDA receptor. DynA inhibition of NMDA receptor function has been suggested to be involved in its neuroprotective action during ischemic and acidic conditions. However, the effect of external pH on DynA inhibition of the NMDA receptor has not been reported. Here, we show that DynA inhibition of the NMDA receptor is dependent on extracellular pH over the range of pH 6.7-8.3, and the inhibition by 10 μM DynA increases at low pH by three- to four-fold in hippocampal neurons and in Xenopus oocytes expressing NR1-1a/2B subunits. Molecular studies showed that the interacting site for DynA on the NMDA receptor is distinct from that of proton or redox sites. Peptide mapping demonstrated important contributions of positively charged residues and specific structural organization of the peptide to the potency of DynA inhibition. Thus, DynA inhibits NMDA receptors through an allosteric mechanism, which is pH dependent and involves the specific structural features of the peptide..
34. Li Zhang, Masako Hosoi, Misa Fukuzawa, Hui Sun, Robert R. Rawlings, Forrest F. Weight, Distinct molecular basis for differential sensitivity of the serotonin type 3A receptor to ethanol in the absence and presence of agonist, Journal of Biological Chemistry, 10.1074/jbc.M207683200, 277, 48, 46256-46264, 2002.11, Ethanol can potentiate serotonin type 3 (5-HT3) receptor-mediated responses in various neurons and in cells expressing 5-HT3A receptors. However, the molecular basis for alcohol modulation of 5-HT3 receptor function has not been determined. Here we report that point mutations of the arginine at amino acid 222 in the N-terminal domain of the 5-HT3A receptor can alter the EC50 value of the 5-HT concentration-response curve. Some point mutations at amino acid 222 resulted in spontaneous opening of the 5-HT3A receptor channel and an inward current activated by ethanol in the absence of agonist. Among these mutant receptors, the amplitude of the current activated by ethanol in the absence of agonist was correlated with the amplitude of the current resulting from spontaneous channel openings, suggesting that the sensitivity of the receptor to ethanol in the absence of agonist is, at least in part, dependent on the preexisting conformational equilibrium of the receptor protein. On the other hand, point mutations that conferred greater sensitivity to ethanol potentiation of agonist-activated responses were less sensitive or insensitive to ethanol in the absence of agonist. For these receptors, the magnitude of the potentiation of agonist-activated responses by ethanol was inversely correlated with the EC50 values of the 5-HT concentration-response curves, suggesting that these mutations may modulate ethanol sensitivity of the receptor by altering the EC50 value of the receptor. Thus, distinct molecular processes may determine the sensitivity of 5-HT3A receptors to ethanol in the absence and presence of agonist..
35. T. Hori, T. Oka, M. Hosoi, M. Abe, K. Oka, Hypothalamic mechanisms of pain modulatory actions of cytokines and prostaglandin E2, Annals of the New York Academy of Sciences, 917, 106-120, 2000.01, A decrease and subsequent increase in nociceptive threshold in the whole body are clinical symptoms frequently observed during the course of acute systemic infection. These biphasic changes in noeiceptive reactivity are brought about by central signal substances induced by peripheral inflammatory messages. Systemic administration of lipopolysaccharide (LPS) or interleukin-1β (IL-1β), an experimental model of acute infection, may mimic the biphasic changes in nociception, hyperalgesia at small doses of LPS, and IL-1β and analgesia at larger doses. Our behavioral and electrophysiological studies have revealed that IL-1β in the brain induces hyperalgesia through the actions of prostaglandin E2 (PGE2) on EP3 receptors in the preoptic area and its neighboring basal forebrain, whereas the IL-1β-induced analgesia is produced by the actions of PGE2 on EP1 receptors in the ventromedial hypothalamus. An intravenous injection of LPS (10-100 μg/kg) produced hyperalgesia only during the period before fever develops and was abolished by mieroinjection of NS-398 (an inhibitor of cyclooxygenase 2) into the preoptic area, but not into the other areas in the hypothalamus. The hyperalgesia induced by the cytokines PGE2 and LPS may explain the systemic hyperalgesia clinically observed in the early phase of infectious diseases, which probably warns the organisms of infection before the full development of sickness symptoms. The switching of nociception from hyperalgesia to analgesia accompanied by sickness symptoms may reflect changes in the host's strategy for fighting microbial invasion as the disease progresses..
36. Hosoi M, Oka T, Abe M, Hori T, Yamamoto H, Mine K, Kubo C, Prostaglandin E2 has antinociceptive effect through EP1 receptor in the ventromedial hypothalamus in rats, Pain, 10.1016/S0304-3959(99)00105-0, 83, 2, 221-227, 83 (4) : 221-227, 1999.11.
37. Kamikawa H, Katafuchi T, Hosoi M, Yamamoto T, Hori T, Hyperalgesic response to noxious stimulation in genetically polydipsic mice., Brain Research, 10.1016/S0006-8993(99)02006-5, 846, 2, 171-176, 846 (2), 171-176, 1999.11.
38. T. Hori, T. Oka, M. Hosoi, S. Aou, Pain modulatory actions of cytokines and prostaglandin E2 in the brain, Annals of the New York Academy of Sciences, 10.1111/j.1749-6632.1998.tb09567.x, 840, 269-281, 1998.05, Proinflammatory cytokines such as IL-1, IL-6, and TNFα are known to enhance nociception at peripheral inflammatory tissues. These cytokines are also produced in the brain. We found that an intracerebroventricular injection of IL-1β only at nonpyrogenic doses in rats reduced the paw-withdrawal latency on a hot plate and enhanced the responses of the wide dynamic range neurons in the trigeminal nucleus caudalis to noxious stimuli. This hyperalgesia, as assessed by behavioral and neuronal responses, was blocked by pretreatment with IL-1 receptor antagonist (IL-1Ra), Na salicylate, or α melanocyte-stimulating hormone, indicating the involvement of IL-1 receptors and the synthesis of prostanoids. IL-6 and TNFα at nonpyrogenic doses also induced hyperalgesia in a prostanoid-dependent way. Furthermore, the preoptic area (POA) was most sensitive to IL-1β (5-50 pg/kg) in the induction of behavioral hyperalgesia. The maximal response was obtained 30 min after injection of IL-1β at 20 pg/kg. On the other hand, an injection of IL-1β (20-50 pg/kg) into the ventromedial hypothalamus (VMH) prolonged the paw-withdrawal latency maximally 10 min after injection. This analgesia, as well as the intraPOA IL-1β-induced hyperalgesia, was completely blocked by IL-1Ra or Na salicylate. Our previous study has revealed that i.c.v. injection of PGE2 induces hyperalgesia through EP3 receptors and analgesia through EP1 receptors by its central action. The results, taken together, suggest (1) that IL-1β at lower doses in the brain induces hyperalgesia through EP3 receptors in the POA and (2) that the higher doses of brain IL-1β produces analgesia through EP1 receptors, probably, in the VMH..
39. Oka T, Hori T, Hosoi M, Oka K, Abe M, Kubo C, Biphasic modulations in the trigeminal nociceptive neuronal responses by the intracerebroventricular prostaglandin E2 may be mediated through different EP receptors subtypes in rats, Brain Research, 10.1016/S0006-8993(97)00802-0, 771, 2, 278-284, 771 (2) : 278-284, 1997.10.
40. Hosoi M, Oka T, Hori T, Prostaglandin E receptor EP3 subtype is involved in thermal hyperalgesia through its actions in the preoptic hypothalamus and the diagonal band of Broca, Pain, 10.1016/S0304-3959(97)03380-0, 71, 3, 303-311, 71 : 303-311, 1997.07.
41. Arimura, T., Komiyama, H. and Hosoi, M.: Pain Disability Assessment Scale (PDAS) -A simplified scale for clinical use-. Japanese Journal of Behavior Therapy. 23(1): 7-15, 1997..
42. Oka T, Hosoi M, Oka K, Hori T, Biphasic alterations in the trigeminal nociceptive neuronal responses after intracerebroventricular injection of prostaglandin E2 in rats, Brain Research, 10.1016/S0006-8993(96)01421-7, 749, 2, 354-357, 749 : 354-357, 1997.02.
43. T. Oka, M. Hosoi, K. Oka, T. Hori, Erratum
Biphasic alteration in the trigeminal nociceptive neuronal responses after intracerebroventricular injection of prostaglandin E2 in rats (Brain Research 749 (1997) (354-357), Brain Research, 10.1016/S0006-8993(97)00471-X, 757, 2, 1997.01.
44. S. Tsutsui, Y. Higashi, M. Hosoi, K. Mine, C. Kubo, Psychosomatic therapy for chronic pain disorder (Lumbago) closely related to conversion disorder as a psychological mechanism, Japanese Journal of Psychosomatic Medicine, 37, 2, 151-156, 1997.01, The case of a 26-year-old woman who had been suffering from lumbago since the age of 14 earlier is herein reported. She also demonstrated claudication because of lumbago. Numerous examinations revealed no abnormal findings except for a slight lumbar disc herniation, and conventional orthopedic therapy such as traction only worsened her symptoms, thus she was eventually admitted to our department of psychosomatic medicine. The psychological interview revealed that she had felt stress from her over interfering mother since her childhood and that she could only avoid the unpleasant feelings by means of her symptoms. It was thus suggested that some psychological mechanism existed as a conversion disorder for her symptoms. She also indicated that her mother, coworkers and the previous medical staff did not show sufficient understanding for her symptoms, and such feelings were also considered to be contributive factors for the continuation of her symptoms. We therefore showed acceptance and sympathy for her pain while taking a neutral attitude to her pain behavior. We also performed family therapy in order to help reduce the stress in the family environment. As a result of this psychological treatment, her pain behavior began to gradually decrease..
45. Oka T, Oka K, Hosoi M, Hori T, Inhibition of peripheral interleukin-1beta-induced hyperalgesia by the intracerebroventricular administration of diclofenac and alfa-melanocyte-stimulating hormone, Brain Research, 10.1016/S0006-8993(96)00705-6, 736, 1-2, 237-242, 736 : 237-242, 1996.10.
46. Mamoru Muraoka, Hiroaki Komiyama, Masako Hosoi, Kazunori Mine, Chiharu Kubo, Psychosomatic treatment of phantom limb pain with post-traumatic stress disorder
A case report, Pain, 10.1016/0304-3959(96)03052-7, 66, 2-3, 385-388, 1996.08, The successful treatment of severe left lower limb phantom pain is reported. Hypnosis and antidepressant drugs were the basis for the treatment which controlled the phantom limb pain and an associated post traumatic stress disorder..
47. Oka T, Wakugawa Y, Hosoi M, Oka K, Hori T, Intracerebroventricular injection of tumor necrosis factor alfa induces thermal hyperalgesia in rats, Neuroimmunomodulation, 10.1159/000097238, 3, 2-3, 135-140, 3 (2,3) : 135-140, 1996.03.
48. Komiyama, H., Muraoka, M., Mine, K., Hayakawa, H., Hosoi, M., Nakagawa, T., Kodama, K., Kubo, C.: Psychosomatic study on chronic pain -Consideration of the treatment and prognosis- . Shinshin-Igaku. 35: 287-297, 1995..
49. Oka T, Oka K, Hosoi M and Hori T, Intracerebroventricular injection of interleukin-6 induces thermal hyperalgesia in rats., Brain Research, 10.1016/0006-8993(95)00691-I, 692, 1-2, 123-128, 1995.09.
50. H. Komiyama, M. Muraoka, K. Mine, H. Hayakawa, M. Hosoi, T. Nakagawa, K. Kodama, C. Kubo, Psychosomatic study on chronic pain. Consideration of the treatment and prognosis, Japanese Journal of Psychosomatic Medicine, 35, 4, 287-297, 1995.01, In the department of psychosomatic medicine, Kyushu University, a chronic pain patient is defined as 'a patient whose pain complaint or social or occupational impairment is in excess of what would be expected from the underlying organic pathology.' We have treated patients of this category by means of various kinds of somatic, psychologic and psychiatric methods. In this paper, 40 cases who had been treated for chronic pain on an inpatient basis in our institute were studied regarding applied treatment methods, their effect, treatment outcome and factors affecting prognosis. The results are as follows: 1) All the subjects were prescribed several kinds of antidepressants and minor tranquilizers as pharmacological treatment with the aim of alleviating the pain. 2) The somatic approach consisted of nerve block, laser and silver spike point electro therapy, all of which were applied to the patients with neurogenic pain. We feel that these methods also have some psychological effect. 3) Some behavioral methods were applied, such as autogenic training (AT), graded exercise quota and other operant techniques (time-out, prompting and token economy). AT helped the patients to effectively cope with pain caused by depressive disorders and psychophysiological mechanisms. Graded exercise quota was applied to teach patients to effectively manage avoidance pain behaviors to fearful situations. Other operant techniques were necessary for controlling more excessive pain behaviors. 4) In addition, some patients received either family therapy or counseling. The former was effective both for patients with depressive disorders whose family system acted as a psychological burden and for patients with conversion disorders who utilized their pain as a communication method. Counseling was necessitated for patients whose interpersonal cognitions were distorted or whose social skills were immature. 5) Treatment outcomes were evaluated from following four aspects; the strength of the subjective pain, the degree of the impairment of daily activity or role functioning and the dependence on medical treatments. Evaluation of the short-term outcome at 1-month after discharge showed 3 excellent, 14 good, 19 fair and 4 poor cases. Evaluation of the long-term outcome at 6-12 months revealed 5 excellent, 18 good, 10 fair and 7 poor cases. 6) Examination of factors affecting prognosis suggested that the most important was to analyse the patients' pain problems from a detailed multiphasic view and to institute the appropriate treatment on the basis of that analysis. On the basis of these results, the possibility was discussed as to how to apply various methods systemically, such as somatic approach, pharmacological treatment, behavioral therapy, family therapy and other psychotherapy, depending on the patients' pathogenesis..
51. K. Mine, F. Kanazawa, K. Matsumoto, O. Tsuchida, M. Hosoi, C. Kubo, A depressive disorder in patients with irritable bowel syndrome and non-ulcer dyspepsia, Nippon rinsho. Japanese journal of clinical medicine, 52, 5, 1329-1333, 1994.05, The relationships between psychiatric disorders and the symptoms of both irritable bowel syndrome (IBS) and non-ulcer dyspepsia (NUD) are herein investigated and discussed. Functional disorders of the small and large intestine induce irritable bowel syndrome. NUD is a syndrome that displays symptoms that might originate in the upper digestive system despite the absence of any organic disorder. In addition, it has also been suggested that the occurrence of NUD is based on a functional disorder of the upper digestive systems. Based on our studies of serious cases with both NUD and IBS, in approximately 50% of the NUD patients as well as about 50% of the IBS cases, a depressive disorder was found to be most closely related to the onset and continuance of the symptoms of either NUD or IBS. According to the evaluations of NUD and IBS as functional disorders and psychiatric disorders, the patients underwent treatment and all demonstrated a good response to the various treatment regimens. It is thus considered that NUD and IBS should be evaluated as both functional digestive disorders and psychiatric disorders..
52. Komiyama, H., Muraoka, M., Mine, K., Hayakawa, H., Hosoi, M., Nakagawa, T., Kodama, K., Kubo, C. : Psychosomatic study on chronic pain -Clinical features of chronic pain and reconsideration on its definition-. Shinshin-Igaku. 34: 489-498, 1994..
53. H. Komiyama, M. Muraoka, K. Mine, H. Hayakawa, M. Hosoi, T. Nakagawa, K. Kodama, C. Kubo, Psychosomatic study on chronic pain. Clinical features of chronic pain and reconsideration on its definition, Japanese Journal of Psychosomatic Medicine, 34, 6, 489-498, 1994.01, In the Department of Psychosomatic Medicine, Kyushu University, a chronic pain patient is defined on the basis of our clinical experiences and reviews of associated literatures as 'the patient whose pain complaint or social or occupational impairment is in excess of what would be expected from the underlying organic pathology'. We assessed the pathogenesis of each patient in this category based on a multidimensional evaluation including organic, functional and psychiatric diagnosis, as well as behavioral analysis and family analysis. In this paper, 40 cases who had been treated as having chronic pain on inpatient basis in our institute were studied regarding their clinical features. The results are as follows: 1) Before the first visit to us, they underwent various treatments at many institutes and several admissions. In addition, some cases underwent one or more operations for alleviation of the pain in vain. 2) An operation for a physical disease, a psychosocial stressor, an injury and a disease with no need of operation were considered to have functioned as the precipitating factor for the pain. Many patients developed their pain from an experience of a noxious stimulus as a trigger. 3) psychiatric diagnosis made according to DSM-III-R showed that conversion disorder and major depression were the two most common disorders and that a few cases had hypochondriasis or social phobia. These psychiatric disorders led to the pain of the patients. As accompanying psychiatric diseases, there existed psychoactive substance abuse, panic disorder, factitious disorder or others on Axis I and some kinds of personality disorder on Axis II. 4) As functional diseases, there were deafferentation pain, reflex sympathetic dystrophy, tension-type headache, irritable bowel syndrome, non-ulcer dyspepsia and aerophagia. 5) The comparison between the characteristics of depressive disorder and those of conversion disorder revealed that patients with depressive disorder were significantly more related to experience of a noxious stimulus. 6) Behavioral analysis suggested that operant learning mainly played a causative role in the pain behaviors of many cases. 7) In the operant pain patients, 4 types of consequence in their environment acted as reward contingent on their pain behaviors. These included solicitous response, avoidance of reality, avoidance of conflict and maintenance of family system. These results suggest that there exists a complicated pathogenesis consisting of various factors behind persistent and intractable pain. Therefore, it is necessary to evaluate chronic pain patients on the basis of detailed psychosomatic assessment. It is thus considered to be important to attempt to understand the psychological, social and existentional meanings of each patient's pain..
54. Hosoi, M., Mine, K.: A study of a case of prolonged RSD -the relation between RSD and somatoform pain disorder-. The J. Japanese Society for the study of chronic pain.12(1): 90-94, 1993..
55. Komiyama, H., Muraoka, M., Oka, T., Hosoi, M., Mine, K., Nakagawa, T.: The role of cognitive-behavioral therapy in the treatment of chronic pain. J. Pain Clinic.12(5): 655-659, 1991..