Department of Psychosomatic Research
National Institute of Mental Health,
National Center of Neurology and Psychiatry, Japan
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Current Research Projects

1. Determination of the pathology of psychosomatic diseases and the development of effective treatment
2. Studies on the pathology and epidemiology of EDs
3. Studies on psychosomatic relationship using ambulatory assessments
4. Other Studies

1. Determination of the pathology of psychosomatic diseases and the development of effective treatmen

Interactions between central or peripheral biological disturbances and psychosocial factors such as stress, emotion, cognition, behavior, and life style are involved in the etiology and maintenance of psychosomatic diseases (PSD) as well as eating disorders (EDs). Currently, any assessment of the mind–body interaction and diagnosis of PSD is primarily conducted by an interview or questionnaire. More objective and scientific methods for the assessment of mind–body interaction and diagnostic procedures are required for clinical and research purposes.
Outside Japan, cognitive behavioral therapy (CBT) is well validated and often used for both PSD and EDs. However, application of CBT in the treatment of PSD and EDs has not yet become a mainstream in Japan. The aim of this collaborative study is to establish an objective assessment technique for the management of PSD and EDs in Japan. In this study, we evaluate the following measures as potential tools for assessing mind–body interactions in both EDs and PSD: Ecological Momentary Assessment (EMA), functional magnetic resonance imaging (MRI), autonomic parameters, stress hormones, cytokines, and intestinal microflora. In addition, we propose and evaluate CBT-based psychotherapeutic interventions for functional gastrointestinal disorders and obesity and EDs.

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1-1. Development of a multidimensional assessment method of psychological stress in daily settings

Capturing a temporal course of psychological stress is essential when assessing PSD. We are developing method to assess psychological stress in daily settings, which is ecologically valid, temporally precise, and multidimensional.

1-2. Development of cognitive behavioral treatment for irritable bowel syndrome (IBS)

Functional gastrointestinal disorders such as IBS and functional dyspepsia are common psychosomatic disorders that have very high prevalence rates and run a chronic course. In addition, they have a large impact on quality of life and place an enormous burden on medical resources. We have developed a cognitine behavioral treatment (CBT) for IBS.

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2. Studies on the pathology and epidemiology of EDs

2-1. Study of biological markers of EDs

Although various biological abnormalities are observed in patients with EDs, most of them reflect secondary impairments due to malnutrition or abnormal eating behavior. No biological marker specific to EDs has been established.
Genetic factors play an important role in the etiology of EDs. We organized a Japanese Genetic Research Group for Eating Disorders consisting of ED-treating facilities throughout Japan. Our collaborative group has conducted several candidate gene association studies and a genome-wide association study using microsatellite markers. In addition to evaluating the related genes, we are conducting advanced studies to determine some possible biomarkers for EDs.
Determining these biological markers will contribute toward better understanding of the pathology of EDs and development of treatment strategies.

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2-2. Functional imaging study of EDs: Assessment of one's self through comparison with others

Distorted evaluation of one's body shape is a central psychopathology in EDs, and body dissatisfaction is a possible predictive factor for developing EDs. We are conducting a functional MR imaging study (fMRI) for body shape comparison.

2-3. Epidemiological studies concerning eating disorders

An alarming increase in the number of teenagers with EDs has been reported in Japan. The objective of this study was to assess the prevalence of EDs. We conducted a survey using an eating disorder questionnaire (EDE-Q) and another questionnaire on risk factors for EDs in 6000 junior high school students. As a result, the frequency of EDs was estimated to be 1.9% among girls and 0.2% among boys. In addition, a traumatic sexual experience was identified as a risk factor for purging behavior.
The psychological burden that the family members of patients with EDs experience has been found to be significant. We are conducting a survey, which aims to establish an effective psychological support for family members of patients with EDs.

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3. Studies on psychosomatic relationship using ambulatory assessments

3-1. Comprehensive understanding of temporal relationships between eating behavior and biopsychosocial factors

We are investigating temporal relationships between eating behavior and biopsychosocial factors based on ecologically valid and nutritionally precise data using ecological momentary assessment (EMA) and a personal digital assistant-based food diary.

3-2. Memory of subjective symptoms and methodological issues in the assessment of subjective symptoms

In collaboration with Prof. Yoshiharu Yamamoto at the Graduate School of Education, the University of Tokyo, we are investigating memory properties of subjective symptoms and discussing methodological issues related to the assessment of subjective symptoms using the day reconstruction method and EMA.

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4. Other Studies

Alexithymia: We have found several subgroups with different personality characteristics in the highly alexithymic group rated by the Toronto Alexithymia Scale (TAS-20).
Psychological stress and physiological tests: We are investigating psychological stress and its recovery using physiological indices.

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© 2011 Department of Psychosomatic Research.