[Adult health problems and coping at life turning points]

At important life turning points, middle-aged adults face many physiological changes (e.g., aging, changes in hormone levels) and alterations in family structure (e.g., children growing up and leaving home). In addition to facing these changes and their impacts, adults must also take on challenges in terms of self-concept, body image, life goals, and life meaning. Illnesses that commonly occur during this life stage include menopausal depression, substance abuse, and anxiety. Traditional treatment models are medical-oriented, but curative effects are limited and hospital visits still occur at high frequencies, resulting in increased medical expenses and disruptions in family life. The authors review the current literature on curative models in this area, and discuss the potential of a combination of physical therapy, cognitive, and existential-humanistic therapy to improve patients' physical strength, self-concept, self-esteem, and self-confidence in an effort to overcome physio-psycho-social disorders and to increase vitality.