Psychosomatic Diseases in Middle Aged (Climacteric) Patients with Chief Complaiint of Vertigo

Abstract

In our practice, the highest incidence of psychosomatic diseases is seen in the middle-aged (climacteric) patients as compared to those in the other periods of life. These patients manifest a variety of symptoms and we often experience many difficulties in treating them. No identical cases have been observed. Therefore, it is not an efficient way to deal with these patients individually. In order to improve such a situation, we attempted to make a practical classification of these patients in order to improve our treatment.The present paper describes the results obtained.1) Subjects : Our subjects consisted of the patients who were ween in our hospital during the past 15 years, whose chief complaint was vertigo. They were all referred to us under a diagnosis of psychosomatic disease or its suspicion because of the intractability of the symptoms observed. The onset age ranged from 45 to 55 years. Only documented cases were included as the subjects of this study. As a result, a total of 206 cases (28 males and 178 females) constituted our subjects.2) Methods : In order to find if there were any common features, the chief psychogenic factors responsible for manifestation of vertigo were classified largely into two groups; that is 1) the somatic treatment related group and 2) the social problem group. These two groups were further divided into some subgroups.3) Results : In the somatic treatment related group in which iatrogenic factors were also taken into consideration, the treatment consisted chiefly of somatic therapy and administration of psychotropic drugs in addition to psychotherapy which was given when so indicated. As a result, the remission rate was about 73% (72 out of 98 cases).As to the treatment for the social problem group, persuasive psychotherapy for various troubles was the chief treatment choice. In addition, various other therapies including getting cooperation of persons related to the patients and administration of psychotropic drugs were performed. The remission rate obtained in this group was about 66% (71 out of 108 cases).In sime cases, the traditional Chinese therapy was also applied, which was often effective if the symptom could be grasted accurately.