Objective
Seventeen patients with FMS were treated with balneo-Morita therapy, which combines the balneotherapy with Morita therapy. After one year of treatment, patients with favorable outcome were compared with those with poor outcome.
Subjects and methods
The mean treatment period was 4.3 weeks. The outcome after one year of treatment was assessed. Patients who were able to return to work without a relapse of FMS were classified into the responsive group (13 cases, 74.6% in all), and those who showed a relapse or were not able to return to work were classified into the unresponsive group (4 cases, 23.5%). The cases of these two groups were compared in terms of biological (physical), psychological, social and existential status induvidually.
Results
There was no significant difference in sex or age distribution between the two groups. In terms of disease entity, FMS can be classified into psychosomatic type (hyperadaptation type) and neurotic type (possible presence of psychosocial-existential problems which are difficult to resolve such as great trauma, or the conditions ranging from neurosis to psychosis). Cases of neurotic type were prevailing in the unresponsive group. Patients were assessed to find out in which of the particular features of biological, psychological, social and existential aspects the notable problems proper to each patient lie.
The number of patients having psychological problems was higher in the unresponsive group, with a significant difference. In one case of the unresponsive group, the condition changed into ME/CFS (myalgic encephalopathy/chronic fatigue syndrome).
Discussion
In the treatment of these patients, the somatic approaches or physical therapy such as pharmacological therapy or simple balneotherapy, should be given more importance for cases of the psychosomatic type. However, psychological therapy should be added to this treatment for cases of neurotic type. The efficacy of the balneo-Morita therapy was compared between the groups as classified by the type of the disease. The therapy was effective in 91.6% of the cases of psychosomatic type, while the efficacy rate was 40.0% for cases of neurotic type. During the period of the balneo-Morita therapy, a tendency of dependency on therapists may appear in patients. Although involution may be allowed transiently for the purpose of introducing catharsis, autonomy should be enhanced eventually. Yuatari (balneo-phenomenon, or balneo-intoxication) is a phenomenon, that develops in psychosomatic confusion resulting from sudden release from tension after the start of balneotherapy. This phenomenon is regarded as catharsis, from which patients are encouraged to establish a new self. Through this therapeutic experience, the therapists lead the patients from involution to autonomy without being so instructed, finally to cause a change in the way of living. In cases of psychosomatic type, this conversion was relatively easily achieved, but in cases of neurotic type such conversion was difficult. It is considered that difficulty in such conversion is attributable to psychological factors of patients (strength of self, severity of trauma, presence or absence of meaning, autonomy).