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High school students (N = 902) in Okinawa were asked to participate in a questionnaire survey which was designed to investigate the psychosocial factors in the psychosomatic symptoms of adolescents. The questionnaire focused on mental distress, perception of school and home environment and psychosomatic symptoms. The Japanese Edition Cornell Medical Index‐Health Questionnaire (JCMI) for evaluating emotional instability and the New TK Diagnostic Test for Parent‐Child Relationship were also utilized. Distress in relationships with family or friends, finding little pleasure in school and/or home, showing emotional instability as diagnosed according to regions III and IV of JCMI, or showing strained parent‐child relationships according to the TK Test items were found to be closely associated with psychosomatic symptoms. In addition, students with human relations problems, especially family problems, tended to have a strained relationship with parents and tended to show autonomic hyperactivity represented by orthostatic dysregulation. Students with peer problems tended to have emotional instability and to find little pleasure in school; they had mental as well as urinary and bowel symptoms. The findings of this study suggest that distresses in family or peer relationships, emotional instability and a strained parent‐child relationship are important factors in the onset of psychosomatic symptoms in adolescents.

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The prevalence rate of severely mentally and physically disabled children (SDC) aged 6–15 years in Okinawa prefecture on 1 May 1989 was 0.74/1000 (143/192 038) according to Oshima's classification, compared with 0.89/1000 (170/192 038) according to the Ministry of Education's classification with minor modifications. The number of children in region classes 1, 2, 3 and 4 of Oshima's classification for SDC were 100, 34, 6 and 3, respectively. The difference (n = 27) between the total numbers of SDC according to the two classifications was mainly because of 21 children categorized as ‘walking with support’ who were included as SDC according to the Ministry of Education's classification but not as SDC according to Oshima's classification. Only region class 1 of Oshima's classification corresponded with region class 25 of the Ministry of Education's classification. The results of the present study indicate that the differences between the two definitions of SDC affect the reported prevalence rates of SDC. Therefore, changing patterns in the prevalence of SDC should be assessed by serial surveys using the same method in each district.

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