障害児と小児神経症,その問題(シンポジウム:思春期の心身症と心身医学的発想,2008年,第49回日本心身医学会総会(札幌))  [in Japanese] Some Medical Issues of Childhood Neuroses in the Handicapped Children(Symposium/Psychosomatic Disorders of Adolescents and Psychosomatic Conceptions)  [in Japanese]

旭川療育センターに入所中の障害児のうちで心身症を発症した痙直型両麻痺の12歳女児,Pelizaeus-Merzbacher病(保因者発症)の14歳女児の思春期症例2例を紹介した.さらに,入所施設における小児神経症の発症状況,その要因ならびに対応の仕方について報告した.73名の入所児童中,心身症が12.3%に認められ,小児神経症が全体として34.2%と高率に発症していた.小児神経症の発症要因として,特に,コミュニケーション能力,家庭環境,親子関係などの背景因子が複雑に関与していた.患児の多くはさまざまな心理的問題を抱えており,出現する症状も多種多様で繰り返す傾向があった.障害児では小児神経症(含む心身症)の発症の閾値が低いことが示唆された.共通の理解に立った多専門的介入が小児神経症の治療に有効であった.

Two cases of the psychosomatic disease of adolescence were reported, who were a 12 year old girl of spastic cerebral palsy and a 14 year old of Pelizaeus-Merzbacher disease. We also showed the medical issues of childhood neuroses, including the incidence, etiology and treatment, which were dealt with at the Hokkaido Asahikawa Habilitation Centre for Disabled Children. Psychosomatic diseases and childhood neuroses were seen in 12.3% and 34.2%, respectively among 73 patients in our habilitation centre, and the occurrence rate seemed to be high. Etiology of childhood neuroses was considered to be a combination of communication disability and background problems such as family environment and parent-child relationship. Many patients had various psychological problems and the presenting symptoms were varied and tended to repeat themselves. It was suggested that the threshold of childhood neuroses (including psychosomatic disease) was very low in the handicapped children. Multi-disciplinary intervention based on common understanding was effective for treatment of childhood neuroses.