更年期障害の心身医学的研究(生涯各期における心身症をめぐる諸問題 : 中年期(更年期))

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We examined 152 cases with climacteric syndrome in our clinic. The average age was 48.5±4.2. We classified the subjects into four types : somatic, psychosomatic, neurotic and depressive by interviews and a psychological test (CMI). Several kinds of therapy were applied to the patients. Conjugated estrogen and dihydroergotamin mesylate were used mainly for the somatic type women. Minor tranquilizers and psychotherapies were used for the psychosomatic or neurotic types, and antidepressant were used for the depressive type women.The menopausal period was classified into three stages : premenopausal (I) in which there is still a regular menstrual cycle, the premenopausal (II) which is judged to occur within 2 years after menopause, the postmenopausal which occurs 2 years or more after menopause, and the postoperative in which the women had undergone a hysterectomy and/or bilateral oophorectomy.We also measured the serum level of luteinizing hormone (LH), follicular stimulating hormone (FSH) and estradiol (E_2) by radioimmunoassay. The t test and qui square were used to compare many factors.Results : 1) The psychosomatic and neurotic types appeared more frequently than the somatic type in the premenopausal (I) women, while the somatic type was observed more frequenly than all other types in the postmenopausal women.2) Treatment was less effective in postoperative women than in premenopausal (I) and premenopausal (II) ones.3) Treatment led to excellent results in the somatic type, 92.1%, and the depressive type, 80%. But effectiveness was rether low in the psychosomatic and neurotic types, 65% and 63%, respectively.4) LH and FSH levels decreased and E_2 increased when treated by conjugated estrogen, while treatment by a minor tranquilizer did not alter the hormone levels at all.Our clinical experience showed that correct diagnosis and selection of appropriate therapy for patients with climacteric syndrome can be achieved by intervewing such patients for at least 30 min. and then classifying them into the most fitting types.
日本心身医学会の論文
1985-04-01

更年期障害の心身医学的研究(生涯各期における心身症をめぐる諸問題 : 中年期(更年期))

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