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假神經症性 精神分裂症의 臨床的 硏究 A CLINICAL STUDY OF PSEUDONEUROTIC SCHIZOPHRENIA

신경정신의학 1976년 15권 4호 p.38 ~ 50
정희연, 곽동일,
소속 상세정보
정희연 (  ) 
고려대학 의과대학 신경정신과학교실

곽동일 (  ) 
고려대학 의과대학 신경정신과학교실

Abstract


In this clinical study, it was intended to reveal the clinical characteristics of pseudoneurotic schizophrenia. Frequency of pseudoneurotic schizophrenia, age and sex distribution, birth order, educational level, marital status, religious background, socioeconomical status, occupation, family history, parental deprivation, premorbid personality, age of onset, predisposing factor, mental symptow, organ of psychosmatic symptom and distribution of sympton were´analyzed. Nature of hypochondriasis and phobia, duration of treatment, result of treatment, past history of treatment and experience of episodic -psychosis were also examined:
The subject of the study were 124 cases of pseudoneurotic schizophrenia out of 8.160 cases of out patients who visited the Department of Neuropsychiatry, Korea University hospital from Jan. 1971 to Oct. 1975.
The result were as follows.
1. The frequency of schizophrenics occupied 9.36 % of all out patients and the frequency of the latetnt schizophrenics occupied 3.00% of all out patients and the frequency of the pseudoneurotic schizophrenics occupied 1.51% of all out patients.
2. The mean age of the patients was 31.82 years old. As to the sex distribution, it was revealed that male occupied 58.87% and female occupied 41.13% of all patients.
3. There was no specific correlation with birth order.
4. The educational level of the patients were revealed higher than other psychosis.
5. According to the occupational distribution, among the male patients, student showed highest rate of 21.93% and among the female patients, housewife showed the highest rate of 62.3%. While 75.00% of them recorded as having certain kind of occupation it was revealed in careful observation that most of them either did poorly in their occupational role or frequently suspended due to their adjustment difficulties.
6. Family history revealed that 11.20% of their family members suffered from psychosis
7. As to the rate of parental deprivation before 15 years old, the rate of father deprivation was 14.52% and the rate of mother deprivation was 9.68%.
8. The mean age of onset was 26.6 years old, clearly older than other clinical types of schizophrenia.
9. Clear precipitating factors were elicited in 85.48% of them. The most frequent precipitating factors were those experience which were recognized as physical threats (31.46%). The next frequent ones were personal seperation (27.42%) and frustrations associated with sexual experiences (16-13%).
10. Among the mental symptoms, anxiety was 37.29%, hypochondriasis was 29.84%, depression was 13.71%, phobia was 12.90% and obsession was 7.26%, Most of their somatic complaints were rather bizarre. The most frequently cbosen bodily past and organs of their somatic complaints were read (33.87%) and cardiorespiratory organs (32.26%).
11. As to the nature of the hypochondrical nature, localized bizarre sensory nature was 37.84% and moving nature 35.14% As to the object of the phobia, the person occupied 50.00% and the death 31.25%
12. As to the duration of illness, 21.77% of the patient had the duration between 6 month and 1 year.
13. As to the past experience of their treatments, 78.57% of the patient had taken drug from -pharmacist´s shop and 75.00% had the other medical treatment and 69.649,o´ had taken,herb drug and 62.50% had psychiatric treatment, In the duration of the treatment from one month to six monthes was 21.42% in the cases of psychiatric treatment less than one month was 66.07%. other mfdical treatment and intermittant herd qAd self-medicated drug users are 32.14% and 37.50%. reciprocally.
14. Five of them (4.03%) had psychotic episodes.
15. The result showed many: clinical significant differences comparing to the. other. schizophrenia, those are, age of onset is older; level of education is higher, tendency of superficial adaptation ´to their occupation is more frequent, prominent precipitating factors are more easily detectable but usually trivial ones, contineous treatment is frequently broken in spite of received numerous various types of treatment, and usually their emotional, behavioral and thought disturbances were so subtle that even their family did not notice their abnormality.
From the above mentioned clinical characteristics and the materials elicited from Rorschach test it well be surmised as the pseudoneurotic schizophrenic patients are constantly seeking social relationship instead with drawing from it which is one of the characteristics of usual schizophrenia but easily upset by trivial events due to their weak ago organization and shallow object relation.

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