Clinico-psychological and Pathophysiological Studies on Fasting Therapy

Although it has been well recognized that fasting therapy is a useful method for the treatment of psychosomatic disorders, the mechanism of effectiveness has not yet been clarified. Therefore, clinico-psychological and pathophysiological studies on the fasting therapy were carried out to clarify the influence on the central nervous function and to establish the objective markers for evaluating the clinical effect. From hospitalized patients, thirty-five cases with psychosomatic disorders and fourteen cases with neuroses were selected for the fasting therapy. The fasting therapy was performed according to the Tohoku University method, and the period lasted for 11 days. The Taylor's Manifest Anxiety Scale （MAS） and the Rosenzweig Picture-Frustration study （P-F study） for the psychological analysis, the Diazepam test （D test） for the psychopharmacological analysis, and the dexamethasone suppression test for the endocrinological analysis were used before, during and after fasting. The results were as follows: 1） The influence on the central nervous functions was studied. The clinico-psychological findings showed a lowering of the manifest anxiety by MAS and a readjustment of the reaction to frustration by P-F study. The psychopharmacological findings showed a decrease of the anxiety tension in the cerebro-limbic system by the D test. The endocrinological findings showed an inadequate change in the responsiveness to dexamethasone administration during the fasting. 2） The objective markers of the clinical efficacy were studied. Cases with high MAS scores and with high levels of Diazepam sedation threshold before fasting showed a reduction into the normal range after fasting. Twenty cases out of 45 （44.4%） were not supperessed by dexamethasone administration during the fasting period alone. Some cases, who were within the normal range in Impunitiveness or Impunitiveness-Ego-Defence of the P-F study after fasting, showed a clinical improvement. The four markers were all significantly related to the global clinical improvement. 3） The above results suggest that the effectiveness of fasting therapy is associated with factors decreasing the anxiety-tension both clinico-psychologically and psychopharmacologically, and with readjustment of the reaction to frustration, as well as to changes in the function of the hypothalamo-pituitary system.departmental bulletin pape