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Spasmodic torticollis is considered as a type or "forme fruste" of generalized dystonia. But not a few cases have psychic factors which relate to an appearence, an alteration or a back ground of this disease. The authors investigated psychosomatic aspects of spasmodic torticollis.Detailed psychological examination was performed to 21 male and 22 female patients with spasmodic torticollis.Twenty-three patients had past history or some associated signs related to psychosomatic diseases such as postural finger tremor, facial spasm, writer's cramp, gastric ulcer.Some social problems were noticed in 34 cases. Such problems were devided into 3 patterns, i.e (1) familial inharmony, (2) occupational trouble, (3) trouble in human relationship. Besides, one patient had an economical problem. However those problems were various depending on each case, and they did not always constitute a psychic etiology of the disease.Certain patients mentioned precipitating conditions for the appearence of symptoms, such as dental treatment, personal dispute, etc. In most cases, however, they only noticed their symptoms in such conditions.As to aggravating factors found in patients' daily life, emotional components were most frequently. In addition, motor activities such as walking also increased the degree of symptoms.As psychological tests, Cornell Medical Index (CMI), Yatabe-Guilford personality test (YG test) and Minnesota Multiphasic Personality Inventory (MMPI) were performed. They were compared to the results of the same tests conducted with hysterical patients.Half of the patients with spasmodic torticollis were found in regions I and II of CMI, and another half were distributed to regions III and IV, while most hysterical cases were distributed to regions III and IV, especially to region IV.In YG test, patients with spasmodic torticollis showed various types. The most dominant was the "C" type especially when compared to hysterical patients.The mean profile of MMPI fell within normal limits among the patients with spasmodic torticollis, whereas the reslts of MMPI in hysterical patients showed strongly psychopathologic aspects. The mean score of Taylor's MAS was 19.8 in the patients with spasmodic torticollis, while that was 28.0 in hysterical cases.The results of those personality tests were not related to the disease's chronicity.The patients with spasmodic torticollis seemed to have their own psychological conflicts, but those conflicts were not constant, and each conflict was different from that of other patients.Those psychologic profiles above mentioned are playing important roles in modifying the symptom of spasmodic torticollis, even if they are not etiological in the development of the disease. It is important to understand and treat spasmodic torticollis from the psychosomatic standpoint.
日本心身医学会の論文
1982-08-01

痙性斜頸の心身医学的側面

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