ストレス多血症と考えられる2症例の心身医学的考察
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There exists considerable literature on the Stress Polycythemia, but little work has been done to study its psychosomatic approach. Therefore, two cases of possible stress polycythemia were reported here from a psychosomatic point of view. The first case was a 55-year old male patient whose occupation was a professor of the department of technology. Patient's chief complaint was anguish feeling on heart. Short-run and VPC was found by Holter's ECG. Blood pressure was 130/60mmHg. Haematological counts were RBC : 620×10^4/mm^3,Ht : 54.0%, and Hb : 17.8g/dl. Microscopic findings of blood in bone-marrow were normal. Psychosomatic interview revealed that patient's character was tenacious, and he was under stress in that he had to conduct twice as many lectures and seminars than those scheduled one year before. In addition, his wife was suffering from anxiety neurosis, and his eldest daughter had been living an asocial life. The second case was a 34-year old male who was an office manager. Patient's chief complaints were insomnia, headache, biting sharp pain on both eyes. Blood pressure was 140/80mmHg. Haematological counts were RBC : 542×l0^4/mm3,Ht : 52.7%, and Hb : 17.4g/dl. Psychosomatic interview revealed that he was kept extremely busy working from early morning till midnight accompanied by poor eating behavior. Regarding his personality ; patient has been spirited and impatient since his childhood. Patient's tenacious personality with a Type A behavioral life pattern has been manifested in his workerholic life style. Furthermore patient has a tendency of being an alkoholic and heavy smoker. His stress situation involved continuous overwork, depression of his wife and death of his father. The common factors in these two cases of possible stress polycythemia can be summaized from the psychosomatic point of view as follows : 1) Patients were middle-aged men and top-managers of their business. 2) Patients have been tenacious in personality and under depressive state due to their workerholic life style. 3) Patients have been anxious because of neurotic diseases of their family members. 4) Antidepressants, anxiolytics and a psychosomatic approach were effective to them. On the basis of the course of haematological count as well as the clinical course, it was concluded that psychosomatic approach was essential for the treatment of stress polycythemia.
- 日本心身医学会の論文
- 1988-08-01
著者
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