男性更年期の評価と対処に関して(男性更年期の心身医学)(第44回日本心身医学会総会)  [in Japanese] Evaluation and Coping in Male Climacterium (Psychosomatic Medicine of Aging Male)  [in Japanese]

男性更年期における問題は,生物・心理・社会にわたる多次元評価理解が必要である.社会的にはライフサイクル的評価の視点が有力である.仕事中毒は中年期に陥りやすい対処様式であるが,破綻しやすいスタイルでもあり修正が必要であることが多い.仕事中毒の成立の背景には戦後の日本の経済成長を支えた利益共同体的価値観が深く関わっていると考えられる.仕事中毒の破綻の一つの形が中年発症の出社困難である.中年期に発生する生活習慣病である肥満,アルコール性肝障害,高脂血症などの中で心理社会的問題と密接に関連しているケースは容易には修正できない.中年期危機には心理社会的価値観の再構築と,ソーシャルサポートの構築が有力な対策となる.

Male climacterium is complicated by various factors. It needs multi-dimensional evaluation including bio-psycho-social factors. It has been recently pointed out that the decrease in free-testosterone secretion is found in male climacterium. In this connection, important psychological factors affecting the male middle age include mood disorders, mid-life crisis latent alcoholic dependence and daily sleep disturbance. Main social factors can be changes in the quality of work procedures and increased quantities of work contents, changes in the husband-and-wife relationships, children's growth and independence, and decline of parental influence (generativity crisis). Ethically a change in the philosophical value is important. Clinical evaluation of the middle age is useful from the stand point of life cycle. Being workaholic is one of the common coping styles which are selected by the middle aged persons. But workaholic coping is also a vulnerable defense which fails easily, and behavior modification becomes necessary for the workaholics. It should be suggested that workaholism is closely connected with the money-centered community value which had given support to the economic growth of Japan. There were many cases of office refusals in the men of 40's as well as those of 20's according to the investigation conducted by the psychosomatic clinic of Toho University. The lifestyle-related diseases found in the middle age such as obesity, alcoholic liver disease, hypercholesterolemia were often closely related to psychological and sociological problems. Improvements in the bad habits were difficult to achieve in the case of alcohol drinking and over eating by the clinical intervention for the company employees at the mental health office. In general, the lifestyle-related diseases of the middle age could not be modified easily. Therefore countermeasures need to be taken to enhance restructuring of the psycho-social values and the social support systems.