A case of psychogenic deafness in a 13 years old boy is reported.
The patient complained of bilateral severe deafness for 5 months and used a hearing aid in his daily life. The pure tone test revealed scale out but the voice test revealed better than the result of pure tone test.
In spite of subjective hearing loss, by EEG audiometry his hearing was normal. His life history and psychological tests showed hysteric sign and character neurosis. On the examination of visual field, a moderate defect was revealed.
By these tests, the diagnosis of psychogenic deafness was established. Then, by a treatment for hysteria, his hearing loss was remarkably recovered.

抄録全体を表示

と転換症状に関する近年の知見を展望する. の診断には非常に混乱がある. またこの言葉の誤用や乱用によって誤診や時には誤った処置をきたすこともある. 追跡研究によると, と診断された患者の約60%に原因となる器質疾患の徴候を認める. 故には, 単一疾患でなく様々な器質疾患を含む不均質な群と考えられる. 今年改訂されたDSM-Ⅲ（Diagnostic and Statistical Manual of Mental Disorders, 3rd ed.）によると, 「」や「性」という言葉は見られず, 主にsomatization disorders, conversion disorders, psychogenic pain disorders, dissociative disordersという病名に分割されている.

抄録全体を表示

一般には起こりにくいとされる睡眠中にも擬似発作を認めたの1例を,脳波学的および心理学的考察を加えて報告した.
症例は,32歳の男性.26歳時,作業中に鉄のバールで右側頭部を強打した.頭部CT検査などに異常を認めなかったが,3カ月後より右手指がつるようになり,次第に四肢および全身が強直するような発作が頻発するようになった.てんかんの疑いにて投薬を受けるも効なく,平成2年7月18日,関西医科大学病院精神神経科に入院した.
入院時より擬似発作を疑い,抗てんかん薬を漸減,中止するも症状は悪化しなかった.脳波検査施行中,発作を認めるも突発性異常波の出現はなかった.また,睡眠脳波記録中,stageIIにおいて発作が出現したが,この時も突発性異常波を認めなかった.
本症例は,頭部外傷を契機として何らかの心的機制により,身体症状としての全身の強直様発作が表出したと思われた.脳波上,てんかんを示唆する異常波の出現はなく,発作中意識清明で発作後もうろう状態も見られなかった.また,自分の欲求が通らない状況下で発作回数が増すなど,発作が出現し易い時と場所が存在した.性格傾向は,演戯性,自己中心性,依存性が目立ち,いわゆる性格に一致した.以上より,本症例の強直様発作は,における擬似発作であると考えた.

抄録全体を表示

We experienced 4 patients with hysteria, who chiefly complained of inability to close their mouths. All these patients were women. The condition should be differentiated from luxation of the temporomandibular joint. Some of our patients had been treated under the diagnosis of luxation of the temporomandibular joint in other hospitals. Open mouth in hysteria seems to be a vastige of a defense mechanism in ancient peoples, and the condition is considered to be a way to expressing aggressiveness.

抄録全体を表示

A lady, who had developed hearing impairment suddenly, presented a shocklike symptom associated with complete deafness, when a stellate block was given. A careful study of life history and following observations revealed that the hearing disorder was one of hysterical basis.

抄録全体を表示

Two patients who had psychogenic reactions in the surgical dental treatment visited our hospital.
One was a 54-year-old married woman and the other was a 34-year-old single woman. Case No.1 was worried for 27 years about her condition stemming from her second delivery, and Case No.2 was worried about exodontia for 14 years.
The psychogenic reactions were chiefly somnolence produced from anxiety caused by local anaesthesia and refusal of all drugs. These conditions were caused by their exposure to old psychogenic traumata and indicated the escape and negative attitudes from the real difficulty of their lives. Generally we call such a condition “conversion hysteria”.
We treated them with psychotherapy which was based upon their self-analysis, and shortly after we cured of their psychogenic reactions.
In these papers, we studied their origins based upon their anxieties.

抄録全体を表示

In this paper, 3 cases of hysterical aphonia were reported.The first case, a 19-year old female patient, lost her voice on account of her lover's violence after quallel with him about a trifling problem. An organic aphonia was excluded by brain CT scan and haryngeal examination. Her aphonia disappeared by supportive psychotherapy and administration of minor tranquilizer without difficulty.The second case, a 17-year old female patient, became pregnant after seve months from living together with her lover. She underwent artificial abortion according to their parents' advice, and was strongly advised to separate herself from him by her aunts. She lost her voice on account of his violence after quarrel with him about the problem of separation. On the afternoon of admission, she was able to speak a little. Her aphonia disappeared gradually by supportive psychotherapy and administration of minor tranquilizer afterward.The third case, a 26-year old female patient, had suspicions about her husband's unfaithfulness for a long time. She had not been on speaking terms with him at times, and lost her voice after the third episode. After admission, her aphonia was not improved by psychotherapy and pharmacotherapy, but disappeared by electroshock therapy immediately.Finally, we discussed some psychological factors relating to hysterical aphonia and therapies for it.

抄録全体を表示

心因性難聴に健忘を伴った2症例を経験した。 健忘は精神医学的には意識の障害を呈する解離性障害の一症状である。 症例1は年齢16歳, 症例2は15歳と, 思春期の女性であり, 難聴, 健忘以外にも多彩な症状を示した。 症例1は精神科において全生活史健忘との合併と診断された。 症例2は, 幼少時より両側高度感音難聴のため経過観察をしており, 既存の難聴が高度で, 他覚的聴力検査で閾値が確認できないので, 精神医学的状況から心因性難聴と推定した。 心因性難聴の場合は, 十分な心理的ケアが必要であり, 特に他の重篤な精神症状を合併している場合は精神科のカウンセリングを要すると考えられた。

抄録全体を表示

患者は20歳の女性で教育学部学生.教育実習を契機に尿閉から始まり全身痙攣, 四肢麻痺といった激しく多彩な症状を呈した.症状を説明できる身体疾患は発見されず, 転換性障害と診断した.心理社会的背景にライフサイクル上の自我同一性獲得の未発達を認めた.入院治療によって患者はますます依存的となり症状の増加を認めた.そのため枠組みを入院から在宅に移行した.しかし症状が激しく, 在宅でも入院に劣らない治療を行う必要があったため, 病室を自室に, 回診を電話と外来受信に, 両親を看護婦に相当させ, 「在宅管理療法」と名づけ実施した.患者は次第に自我を確立し, 軽快した.入院により悪化する転換性障害例では, 入院治療の質に値する在宅での治療が有効である.

抄録全体を表示