Clinical Features of the So-called Vegetetative Dystonia(Pathophtsiology and Treatment of Autonomie Nervous Dyafunetion)

Abstract

The so-called vegetative dystonia is a disorder characterized by the absence of tissue pathology which explains the origin of symptoms complained by patients in general. Accordingly the patients with functional symptoms are diagnosed occasionally as the so-called vegetative dystonia by the general practitioner. In this presentation, 132 patients who were , diagnosed to have functional symptoms at our psychosomatic clinic were analysed. The major diagnoses included 32 cases of depressive state or depression, and followed by irritable bowel syndrome, anxiety neurosis, hysteria in that order. From the study of psychological etiology in these patients, conversion reaction which was a similar condition to hysteria, was found most frequently which was 35%, The second highest, that is 32%, was anxiety and tension reaction, followed by depressive state or depression which was 28%. The responses of the autonomic nervous system to the mecholyl test were classified into Types S, N, and P according to Okinaka's criteria. In these patients Type P was found to be 65% while Type N (normal type) was in only 13%. Beside the Cornell Medical Index (CMI), which is a widely used personality test with questionnaires in our country, was performed. Grade 4 and grade 3 in Fukamachi's classification were considered to indicate neurosis and neurosis suspect respectively. 63% of these patients was diagnosed as neurosis or neurosis suspect. From the above results, autonomic disturbances seem to occur as comcomitant symptoms of psychogenic illness, such as anxiety neurosis, hysteria, and depressive state or depression. Therefore, the term psychoautonomic dysregulation syndrome should be chosen primarily because the functional symptoms may not only occur as an integral clinical picture but also as an accompanying symptom of many different disorders, particularly psychogenic illness.