クオリア概念を導入したセネストパチー患者との対応の試み

抄録

This paper reports a case of cenesthopathy managed by our dental department and psychiatrists for a period of five years. A sixty two year old male patient visited our office on the recommendation of his psychiatrist, complaining of oral malaise on the left palatal region of the mouth due to a “foreign body”. He believed that this “foreign body” was present in his mouth, describing it variously as a string, a club, a ring, a wire, or a sausage. There was, however, nothing in his mouth that corresponded to his complaint. He had been already diagnosed as having cenesthopathy by his psychiatrists.
The author applied the qualia concept to management of the patient. Recognition of his oral malaise as an example of intentional qualia brought two advantages to patient management. The first was that it became possible to regard his oral malaise as the reality. The second came in the sympathetic acceptance of his frustration. The author was able to clearly refute the existence of the “foreign body” at the place described in the oral region. The patient was gradually convinced that the “foregin body” did not really exist in his mouth. The author suggests that the dentist's role in the management of a patient with cenesthopathy is to find ways to assure the patient of the non-existence of the foreign body, as a trusted professional.