神経性咳嗽によると思われる第一肋骨骨折の1例

概要

論文の詳細を見る
Fractures of the first rib are generally uncommon. Particularly, stress fractures of the first rib are rare. The authors report a case of the stress fracture of the first rib due to heavy continuous cough, believed to be psychogenic in origin. The case is of a 36-year old single nurse who was referred to the department of psychosomatic medicine for having fractured her first left and right seventh ribs due to heavy continuous cough whose organic causes could not be found. During the first interview with a psychologist, she became aware of the fact that her cough had started on the third anniversary of her father's death, and that she had not mourned the loss of her father sufficiently, as he died of cancer of the pancreas at the hospital ward where she worked. At work, she could not express her grief due to her overadaptive Personality, neither could she share with the grief of her family, to whom she felt responsible that she, as a nurse, could not have detected her father's cancer at an earlier stage. The "nervous cough" began on the third anniversary of her father's death, Which may be an "anniversary reaction" in a wide sense of the term. The authors discuss the mechanisms of the stress fracture, the psychological process of "mourning work" and how she had not undergone this process, and finally, they point to the need for holistic medical attention in general city hospitals.
日本心身医学会の論文
1983-02-01