耳鼻咽喉科における分裂病圏患者の検討

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  • PSYCHIATRICAL AND SOMATIC SURVEY ON PATIENTS WITH PSYCHOTIC COMPLAINTS IN ENT CLINIC
  • ジビ インコウカ ニ オケル ブンレツビョウケン カンジャ ノ ケントウ

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Clinical survey was performed on 47 psychotic patients who visited the ENT clinic in University of Tokyo Hospital from 1974 to 1977.<br> All of them were recommended to visit psychiatrical clinics, because they were suspected to be paranoid psychosis by an ENT specialist. Thirty-four patients could be followed up and it revealed that they were classified to definite scizophrenia (16 cases), and border-line psychosis (18 cases). The latter could be divided into 3 categories, i., osphresiophobia (9 cases), cenesopathia (6 cases), and others (3 cases).<br> Sixteen patients of scizophrenia had the following distinguishing features; <br> 1) They were 17-34 years old, and younger than neurotic patients. <br>2) Various kinds of chief complaints were noted, and started in their teens in most cases. <br> 3) Eight patients (50%) had undergone surgery. <br>4) Twelve patients (75%) had histories of psychiatrical treatments.<br> 5) Ten patients (63%) were jobless. <br>6) All of 16 patients were not married. <br>The features above mentioned were significantly different from those of the neurotic patients. <br>The clinical features of 18 border-line psychotic patients were similar to those of neurotic patients, however, they had peculiar complaints.<br> Scizophrenic patients could be divided into 2 groups by their complaints. The 1st group had hypochondriacal complaints which were not directly related to the delusion or hallucination. The second had somatic complaints based on the delusion or hallucination. The first group patients were significantly younger than the second group.<br> The osphresiophobia patients believed that their "bad-odors" were due to sinus troubles. However, the bad-odors or sinus troubles were not found objectively.<br> The cenestopathia patients were characterized by their peculiar complaints, for example, many insects moved into my brain"<br> The medical treatment or surgery had no effect on the complaints of these two border-line groups.<br> It should be noted that there were hypochondriacal complaints observed in the rest three patients. These complaints did not seem to be related to delusion or hallucination. However, detailed survey showed these patients had specific persecutory delusion. For example, a patient believed that the tinnitus was due to poisoning by her husband.<br> Otolaryngologists should be careful of handling psychotic patients with somatic complaints and introduce them to psychiatrists as soon as possible, because they can not realize their present situation.

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