心身症と身体表現性障害-力動精神医学の立場から-(心身症と身体表現性障害)(第27回日本心身医学会総会)

抄録

Psychosomatics are originally physical illnesses in which some psychological factors have participated in the course of those illnesses from the onset. On the other hand, somatoform disorders as defined in DSMIII could be understood as physically manifested neuroses. Therefore, the somatoform disorder has a process by which the body is used for a psychological purpose or for personal gain. PSD has a disturbed somatic function by which an unstable self-supportiveness has raised a chronic tension since his early childhood, We have found that distribution rates of mental disorders by DIS diagnosis (NIMH Diagnostic Interview Schedule) are 30-60% in physical patients in three hospitals. And so-called psychosomatic patients, such as diabetes mellitus, bronchial asthma and hypertension, have fewer mental disorders. I believe that the PSD patient has a defect in manifestation capacity of psychic symptom. Symptomformations in PSD are influenced by these special characteristics of the patient's personality. Therefore, we should consider some differences of psychodynamics between both disorders in their treatment.