透析患者における精神障害に対する治療の重要性  [in Japanese] Therapeutic Importance for Mental Disorder in the Patient on Dialysis  [in Japanese]

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Author(s)

Abstract

透析患者は日常生活の制限,喪失体験,死と直面するストレスなどからうつ病をはじめとする精神障害を有することが多い.筆者は透析専門医のみでなく,心療内科医としても診療を行っているが,その立場から透析現場における精神障害に対する治療の重要性について,筆者がかかわった5症例を提示して述べてみたい.5症例の内訳は3例のうつ病と2例のパニック障害であり,それぞれの患者に対して心身医学的面接およびSSRIを主とした薬物療法を行うことにより,精神症状の軽減が認められ,透析治療の円滑な継続が可能となった.今回の経験から,透析患者の精神障害をより早期に把握し適切に治療することの重要性が示唆されたが,日本の透析医療は,身体的治療において世界最高水準を達成しているが,心理面へのアプローチは不十分であり,サイコネフロロジーという分野でのさらなる研鑽が必要であると思われた.

Patients on dialysis tend to have mental disorders including depression which is related to limit actions of everyday life, experiences of loss and stress in the face of death. I have been engaged in a dialysis medical care not only as a specialist in dialysis but also as a psychosomatic physician. From such a standpoint of mine, I viewed the therapeutic importance of mental disorder in the dialysis spot by presenting 5 cases I was concerned with. Five cases consist of 3 patients of depression and 2 of panic disorder. Recovery from their psychiatric symptoms was made in all these cases by interviews from the psychosomatic viewpoint and administration of SSRI. It seems to be important that we grasp mental disorders of patients on dialysis in the early stage and cure them adequately. Dialysis medical care in Japan has achieved the world highest standard in physical treatment, but an approach to its psychological aspect is still insufficient. It seemed that further study in the field of so-called Psychonephrology was necessary.

Journal

  • Japanese Journal of Psychosomatic Medicine

    Japanese Journal of Psychosomatic Medicine 52(11), 1026-1033, 2012

    Japanese Society of Psychosomatic Medicine

References:  9

Codes

  • NII Article ID (NAID)
    110009544098
  • NII NACSIS-CAT ID (NCID)
    AN00121636
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    0385-0307
  • Data Source
    CJP  NII-ELS  J-STAGE 
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