2014 Volume 13 Issue 1 Pages 72-80
[Background] In the case of pseudoneurosis(Frankl1)), physical illnesses(functional or organic disorders)are left unnoticed and diagnosed as psychological disorders(depression or neurosis)instead rather carelessly and hastily. This paper is a study of a pseudoneurotic patient whose condition caused a misdiagnosis and misprescription. The patient had inadequately treated Hashimoto's thyroiditis and arteriosclerosis obliterans. Her former physician, however, had misdiagnosed her illness as depression and prescribed medications accordingly, which led to a marked decline in her ability to perform activities of daily living(ADL)and her quality of life(QOL).
[Subjects] The patient was a 75-year-old female. Her chief complaint was pain spreading all over her lower limbs. Having been diagnosed with depression and given antidepressants and anticonvulsants by her former physician, she was troubled with the sense of fatigue and double vision. Her life was eventually disrupted, which brought her to our hospital. While adequately treating her Hashimoto's thyroiditis, we administered physiotherapy(acupuncture)and psychotherapy(logotherapy)within the framework of our integrative medical practice.
[Results] Our treatment was aimed at improving the function of thyroid glands, homeostasis, and haemodynamics of the patient. The combination of the therapies helped to reduce her lower limb pain from which she had suffered for 10 years. Exercise therapy also contributed to pain relief, which led to her realization that active involvement in pain management through physical activities was worth the effort. Subsequently, she came to be able to manage her symptoms. There was a correlation between the changes in her haemodynamics and pathological conditions(and particularly the values of systemic vascular resistance).
[Conclusion] Patients with pseudoneurosis do not respond well to treatment with psychotropic medication. They rather suffer from side effects of medicine. As a result, patients tend to report a wider range of complaints and the assessment of their condition becomes more difficult. This case gave us a conviction that successful treatment of pseudoneurosis would require a correct diagnosis and bio-psycho-social-existential understanding, or comprehensive knowledge of each patient.
