1.Middle-Aged Farmers' Alcoholism in a Few Examples
Journal of the Japanese Association of Rural Medicine 1977;26(4):657-660
With reference to three cases of subacute alcoholism which occurred among middle-aged farmers, a study was performed primarily on the psychological factors which were observed before and after the incidence.
1) Discord between parents and children due to the latter's unwillingness to become heirs to their farm household, difficulty of having access to a job due to a drop in physical strength after the affliction of a disease to make up for this hollowness were observed before the incidence.
2) At the time of the incidence, the patients were found in a state of slight reactive depression, such as uneasiness and loneliness, displeasure and loneliness, and hollowness and loneliness, and this state was traceable to the predisease characters and environmental factors.
3) The drinking habit featured an escape from the feelings of displeasure, as it shifted from a nightly practice of slight drinking to a practice of toping due to a rapidly increasing mental reliance.
2.Statistics on Putpatients with Senile Psychiatric Disorders (1960-74) With Special Reference to a Study on the Prevalence Rate and the Initial Diagnosis Findings
Yoshio Kamioka ; Yoshio Horiguchi ; Shigeru Takahashi
Journal of the Japanese Association of Rural Medicine 1976;25(2):83-90
With respect to statistics on out patients with senile psychiatric disorders, a few reports have thus far been made available by university hospitals in major urban areas but none from any rural general hospitals. This study is an attempt to grasp the real status of senile psychiatric disorders as observed in outpatient clinics.
1) There have been signs for a yearly rise in the prevalence rate of senile psychiatric diseases, and there is the possibility of diagnosing new patients at a rate of one to six aged people (60 years of age and over).
2) Of all the patients, 45% came directly to our hospital, whereas 55% either were referrals from other clinics or came to the hospital after their consultation with other clinics. Of the latter group, 55% were referred by other departments of the hospital, 38% by outside physicians in our district, and 7% by local administrative offices. This finding appears to suggest that the incidence of hypertension and other somatic complications is high among aged people and also that phsychiatric disorders may sometimes manifest due to somatic disorders.
3) A check of the prevalence by month reveals that the prevalence is highest in March, high from spring to summer, lowest in autumn and low in winter. In this respect, there exists a difference between the organic diseases and the functional diseases. In the former group, the prevalence is concentrated in spring and summer, whereas in the latter, the prevalence remains high from spring to early summer, low in summer and transiently becomes high in early autumn.
4) By sex, the prevalence rate is 52% for males and 48% for females. By age, the prevalence decreases with age and takes a sharp downturn after the age of 75.
By type of disease, senile organic diseases (Group A) account for 54.4%, functional diseases (Group B) 40.0%, and other organic diseases (Group C) 14.5%. Group A increases with age among males, whereas it is concentratedly high among males of 75 years of age and over. Group C is significantly greater among males.
5) A check of the trend of each disease group in the past 15 years indicates that there have been signs for a rise for each group but the rises are significant particularly for Groups B and C. In the latter half period, the percentage of Group B is greater than that of Group A. Against this background, there seems to be a rise in the incidence of psychiatric diseases among rural females.
6) The hospitalization rate stood at 17.5%. By sex, the rate was 20% for males and 15% for females. By type of disease, the ratio stood at 21% for Group C, 17% for Group A and 16% for Group B.
By place of residence, differences between the towns and the villages (27% for the towns and 9% for the villages) were observed in Group A of females, suggesting that many females in the towns are placed in the circumstances where difficult problems tend to crop up with respect to their matrimony or their sharing the same house with other members of their families. As regards clinical symptoms, it was found that there are many patients with severe auxiliary symptoms, such as delirium, hallucination and paranoid symptoms, in addition to advanced dementia.
3.A Case of Poisoning with Smithion Leading to Chronic Psychiatric Symptoms
Yoshio Kamioka ; Takuo Nakajima ; Yoko Okuno
Journal of the Japanese Association of Rural Medicine 1980;29(4):678-683
A 30-year-old male with manic-depressive psychosis took in 30ml of undiluted Smithion to commit suicide. Ten hours or so later, he was found in state of subconsciousness and admitted into our hospital.
1. From the initial trance, he fell into a twilight state. After suffering from an amnestic syndrome and encountering difficulties in concentrating his attention, he was found in a depressive state on the 18th day. This depressive state was presumably a recurrence of the depression with which he had once suffered and therefore proved different from the depressive state unique to organophosphate poisoning.
2. In respect to the psychatric symptoms caused by acute and subacute organophosphate poisoning and its sequela, a study is made on the basis of literature to make some comment.
3. After a clinical course of two-and-a-half years, it was found that there were a slight degree of disturbance to registration and a drop in mental capacity. These were considered sequelas. These symptoms would not hamper his everyday life, but there were signs of a rise in the sense of quilty conscience and misery when he was in a depressive state.
4. EEG indicates that the waves were slowing and paroxismal or sporadic small spikes. Two years later, EEG-findings were slightly abnormal with many sporadic slow α waves. No abnormalities were observed in computerized tomogram.
4.Alcohol Dependence in Women
Yoshio Kamioka ; Shinichi Nishimura ; Nobuo Kawahara ; Masayuki Kano
Journal of the Japanese Association of Rural Medicine 1983;32(1):47-51
This report presents five serial cases of female alcohol dependence treated at neuropsychiatric division of the Saku Central Hospital for the past two years, with special references on descriptive and clinical features.
1) In rural communities, alcohol dependence in women appears to be detected and treated in their earlier stage than men. This may be ascribable to a fewer number of female drinker and closer interpersonal relationship as compared with large cities.
2) All five cases in this clinical study were secondary alcoholism which had an affective disorder antedating the onset of alcoholism. Of them, three (64, 63 and 49 years of age) were with depression and two (35 and 33 years of age) were with psychoneurosis.
3) Suicide attempt was made by a 35-year-old woman, who had experienced loss of a close interpersonal relationship and had been conflicting with her husband. This may suggest that female alcoholics are more likely to commit suicide.
4) No significant relationship was found between drinking pattern and menstrual cycles in two cases with menstruation.
5) Although we have never experienced fetal alcohol syndrome up to present at our hospital, there are several foreign literatures on that subject. It must be required to let female alcoholics aware of this syndrome.