잠시만 기다려 주세요. 로딩중입니다.

哀悼過程과 精神疾患에 關한 硏究

A Study on Mourning Process relating to Mental Illness

경북의대잡지 1974년 15권 2호 p.23 ~ 42
강석헌,
소속 상세정보
강석헌 (  ) - 경북대학교 의과대학 신경정신과학교실

Abstract


Of all functional mental illnesses, mourning process is rather unique in that it has a definite cause and assumes a self-limited clinical course as well as its final outcome. In reviewing the literature on the subject, numerous psychiatric studies have been done, however, mostly by Western authors. And these studies are primarily focused on two areas : intensive psychoanalytic case work and extensive clinical study on symptomatology ana management of acutely bereaved patients.
Furthermore, pathological mourning has also teen studied as well by the several authors, again in the Western culture, especially in relating to other mental illnesses.
In studying mourning process in particular, culture climate has to be taken into consideration, as is true in general psychiatric field, culture exerts a great influence on psychiatrtc symptomatology.
There has been practically no systematic study done on the subject in Korean cultural context.
This study is aimed at two aspects: Overview on mourning process in relating to mental illness, and intensive clinical analysis of mourning patients among the mentally ill in our culture.
A. Overview: Out of 933 psychiatric inpatients admitted in hospital from January 1967 to August 1974, the bereaved group was studied in comparison with the non-bereaved as a control group, whose diagnosis was matched with the bereaved.
B. Intensive Study: A clinical of 36 pathological mourners who have been treated by the author during the last two years.
Summary of this study is as follows;
A. Overview.
1. Out of 933 psychiatric inpatients, 63 cases (6.6%) were indentified as having history of bereavement within one year prior to their admission.
2. The bereaved was roughly three years older than the non-bereaved and interestingly male patients in bereaved group were predominant in the early thirties.
3. As to the kinship with the deceased, parental loss accounted the most up to 54% and as to the circumstance of dying, nearly half of deaths occured suddenly and unexpectedly.
4. The incidence of affective disorders, particularly neurotic and psychotic depression, ws far greater among the bereaved than the non-bereaved ; ratio being 2.7:1.
B. Clinical Analysis.
1. In view of the onset of symptom, clinical diagnosis and course of the mourning, three rather distinctive types could be identified in the process of pathological mourning: (1) acute hysterical type (2) delayed depressive type, and (3) psychotic regressive type.
2. Clinical symptoms were summarized in respect to (1) initial reaction to bereavement (2) general symptoms and (3) unusual symptoms directly related to the deceased.
Initial symptoms were a startling shock, affective numbness, hysterical symptom formation and psychotic breaks, which were sooner or later followed by general symptoms, e.g., anxiety and depression (100%), sleep disturbance (64%), headache or heavy head (47%), painful complaints or abnormal sensation of body parts (46%), respiratory symptoms (47%), digestive symptoms (31%), overdrinking or delinquent behavior (17%) and finally psychotic regressive symptoms (28%).
3. The unique symptoms found in pathological mourning process, i.e., symptoms directly related to the deceased, were summarized as follows; death fear and wish including suicidal attempts, symptom identification with the terminal illness of the deceased, reactivation of another previous mourning, guilty preoccupation with the last contacts with the deceased or terminal scene of dying, anniversary reactions, strange behaviors during the funeral, sense of the deceased being alive, and posession syndrome, etd.
Dream contents were analyzed into several themes; the deceased returning alive, aggression and guilt toward and rejection from the deceased, help from the deceased, repetition of the funeral and prophetic dream. The therapeutic significance of dream interpretation was also discussed.
4. The attitude of the pathological mourners toward the rest of family members had become significantly changed as follows; (1) overdependence, (2) aggression and resentment, (3) self-blame and withdrawl, and (4) becoming the target of other family members´ hostility as well as reactivation of previously existed family conflicts.
5. In treating the pathologic mourning patient, the following aspects were particularly emphasized for a favorable outcome; (1) strong supportive attitude, (2) activation and acceleration of mourning process, and (3) family intervention.
Finally, some of the findings were compared with the studies done in Western culture, and a suggestion was made for the future study on this subject in Korean culture.

키워드

원문 및 링크아웃 정보

등재저널 정보