心理的因子の表現型としての肩関節脱臼

抄録

Psychological factors have seemed to play an important role in voluntary shoulder dislocation. Nevertheless, there are no detailed reports of those who have received psychiatric treatment. We would now like to report the following 4 cases whose shoulder dislocations were caused as a manifestation of psychological factors.
Case 1: 28 y. o., female. When the patient was about 16 years old, she dislocated both shoulders by minimal trauma; then, voluntary shoulder dislocation developed. She underwent five operations at a certain hospital from the age of seventeen. As the dislocation had recurred within 6 months postoperatively on each occasion, she visited our clinic. As we recognized split object relations, we told her to have a psychiatric examination. As a result, it became clear that she had a borderline personality disorder and the dislocation was a trend of autoclasia.
Case 2: 22 y. o., female. This case is the similar disorder to Case 1, but, just a slight.
Case 3: 15 y. o., female. Voluntary shoulder dislocation and pain appeared in her left shoulder two years ago. As her relations with her mother were unnatural, we recommended a psychiatric examination. The result clarified that an adjustment disorder during adolescence existed.
Case 4: 23 y. o., female. Two years ago she suffered from traumatic dislocation caused by a traffic accident, and lost her fiance. Then, after she started going out with another man, dislocation of the shoulder began to occur at twilight accompanied by a syncope-like episode. Though it was spontaneously repositioned under general anesthesia, the dislocation occurred again when she came out from under the anesthesia. Therefore, we requested the cooperation of the psychiatric dept.. As a result, she was diagnosed as having hysterical neurosis.