心因性疼痛を来した2例 : 特に心理機制と治療薬剤について

概要

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We reported two cases with psychogenic pains. They complained of persistent pains and visited various hospitals. Each had local anesthesias and acupunctures as well. Personality deviations common in these two cases were lack of reality-testing and cooperation, rigidity and persecution complex. MMPI showed high scores in hypochondriacal. depressive and hysterical scales.Case 1 was a 30-year-old male with psychogenic facial pains which had persisted over 6 years. Communications in his family were very poor and limited, and he strongly supressed aggression towards his parents and his younger brother, which seemed to be closely related to the symptom formation.Case 2 was a 39-year-old female with conversion hysteria who had had abdominal operations four times. She began to complain of abdominal pains seven years ago when she had an operation of myoma uterii. Total removal of uterus may symbolically suggest the loss femininity Besides abdominal pains, she showed hyperventilation, opisthotonus and astasia.As for the drg treatment, benzodiazepine derivatives, carbamazepine an tricyclic antidepressant were not effective to Case 1 and Case 2,but relatively high doses of levomepromazine were effective to those cases. Levomepromazine might be a useful drug when the patient resists various drug and other treatment.
日本心身医学会の論文
1981-02-01