Diagnostic Problem of So-Called Vegetative Syndrome(Pathophysiology and Treatment of Autonomic Nervous Dysfunction)

Abstract

We examine our classification using DSM-III, a psychological test(TMI), the autonomic nervous system function test and time course of diagnosis. Our material includes 88 cases with unidentified clinical symptoms who visited our clinic of Psychosomatic Medicine Toho University. Generalized anxiety disorders counted the greatest number of 'cases in our subjects according to DSM-III. The second largest were psychological factors affecting physical conditions. The third included somatization disorders. The fouth were panic disorders. The fifth was a group of hypochondriasis. The last were dysthymic disorders. The patients with panic disorders complained more symptoms than other 5 diseases. The number of somatic symptoms of somatization and panic disorders was significantly higher than psychological factors affecting physical conditions and hypochondriasis. Psychological symptoms of dysthymic disorders revealed 3.0 complaints whereas the other 5 diseases below 1.0. Psychological symptoms of dysthymic disorders were significantly higher than somatization disorders and psychological factors affecting physical conditions. Psychological factors affecting physical conditions found many abnomalities ' of MV and orthostatic ECG. This was followed by somatization disorders. We made a comparison between our classification and the 3 type classification (Abe's method) of 6 diseases using DSM-III, which, however, showed no significant differences. There was no significant difference between TMI classification of 6 diseases. Concerning Case l, we learned after seeing him seveval times that he manifested an illness prone behavior in order to get compensation money. The second case with so-called vegetavive syndrome was reported. He was diagnosed as pathological gambling after treating several times. Thus so-called vegetavive syndrome turned out to be a different disease after having clarified psy.chosocial backgrounds during treatment. The diagnosis of so-called vegetative syndrome is much different from the diagnosis of malignant tumor by biopsy. So-called vegetative syndrome can be understood as a tentative diagnosis which depends on the amount and nature of the patient's information. A new diagnosis different from so-called vegetative syndrome can be confirmed after treating the patient for some time. Thus it would be more adequate to apply the diagnosis of vegetative syndrome tentatively, and not as a unit of disease entitity.