眼窩・下内側面の皮質下白質切截術(orbito-ventromedial undercutting)施行前後における Rorschach 反応の分析

抄録

Thirty-six patients (19 males, 17 females: atypical schizophrenia; 3, typical schizophrenia; 9, depression; 11, neurosis and other psychiatric disorders; 8) were operated on according to orbitoventromedial undercutting by Hirose. In all cases, the Rorschach test was carried out and daily behaviors were studied. Thirty-one scales of the test were subjected to multivariate analysis whereas the behaviors were evaluated according to the following criteria, i.e., A: recovered or symptom free, B: markedly improved, C: moderately improved, D: slightly improved and E: not improved. The following results were obtained.
1) The evaluation of behaviors is as follows. A: 12 cases, B: 9, C: 9, D: 6, E: none.
2) It was found that scores of F+106% and R+106% scales were significantly higher after the operation than before; that correlation coefficients between the scores before and after the operation were considerably high.
3) Factor analysis followed by varimax rotation was carried out. Six factors were extracted, i.e., (F1) sensitivity to emotional stimuli, (F2) ego-strength, (F3) obsessional rigidity, (F4) reaction time, (F5) anxiety and tension and (F6) empathy. It was revealed that F2 was high in atypical schizophrenia, depression and neurosis, and that F2 and F6 were significantly different in terms of the factor scores among the four groups A, B, C and D; F2 was highest in A, and lowest in D regardless of whether it was before or after the operation. F6 showed high scores in both A and C, and low in D.
4) Multiple discriminant analysis was applied to the data of the Rorschach test before the operation, by classifying 36 subjects into the four groups A, B, C and D. As a result, high rates of correct diagnosis were obtained, i.e., 100% for A, 78% for B, 56% for C and 100% for D. When the groups C and D were combined into one group (C+D) the highest percentage (100%) was seen in A, followed by B (89%) and C+D group (87%). When the groups A and B were combined into one group (A+B), the percentages of correct diagnosis were 81% for A+B, and 93% for C+D.
In conclusion, it can be said that scales of the Rorschach test have been proved to be valid for predicting mental and physical states after the orbito-ventromedial undercutting.