Abstract
In the course of SLE, dermatological and physical symptoms such as erythema, loss of hair, hirsuteness, obesity, etc. appear which are related also to the steroids treatment in the young women. While we examined the psychiatric manifestations of SLE, we noticed the two cases whose anxiety or fears for their dermatological and/or physical symptoms seemed to influence their psychiatric manifestations, namely the disturbance of ego-consciousness or body-image. In case 1,the patient had actual hirsuteness as a dermatological symptoms of SLE. As she knew by delusional intuition that she expressed the feeling of anxiety and of strong hatred about obesity. In this case, as the disturbance of ego-consciousness increased, the anxiety about her physical symptoms and death became tangible. It was considered that her suicidal attempt and severe depersonalisation appeared as the means to overcome such anxiety. In case 2,the patient had excessive obesity by the steroids treatment. As a result she was worried about being slandered by her friends. Finally, she became delusional and refused to take any meals or drugs. In this case, we thought that her dissatisfaction with or inferiority complex about obesity caused by steroids was the source of her confusion of self-identity and delusional thought. Besides, an anorexia nervosa-like symptom in this case was thought to be closely related to the disturbance of body-image based on the severe obesity. We viewed such psychiatric symptoms in the course of physical diseases or steroids treatment on the basis of some papers. We also added our opinions as to the psychiatric manifestations of these patients with SLE which seemed to be related deeply to the physical symptoms. It seems very useful and important, in the psychotherapeutic support to the problematic patients of SLE, to understand their mental states such as discussed above.
