脊髄損傷患者にみられた精神症状
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概要
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The author experienced two cases of patients who showed psychiatric symptoms a few years after spinal cord-injury and considered psychological aspects of spinal cord-injured patients. A 40-year house wife met a traffic accident caused by her husband and got injured in her spinal cord 4 years ago. At the same time the accident bought her daughter paralysis. Before the accident she had been diligent and persevering. After that, she had been thought to adapt herself to the spinal cord-injury. However she develped a sudden possessive state. She accused her husband who caused the accident. On the other hand, she expressed guilty feeling toward her family whom she had depended on. She showed aggressive feelings toward medical treatment. She showed resistance to psychiatric treatment. A 20-year male injured his spinal cord when he jumped into a swimming pool 3 years ago. He had been denying his paralysis, especially disability to walk after the trauma. When an orthopedist said to him that he could not walk, he showed a transient acute confusional state. After that, he showed depressive symptoms. But he accepted his impairment, as he identified himself with the other spinal cord-injured patient. Generally speaking, spinal cord-injured patients often deny his paralysis. The patient's place in the life cycle can provide clues to their psychological vulnerability. Especially adolescent patients must be faced with identitiy crisis. Patients whose offender is one of their family members develop ambivalence toward them. Some of them have aggressive feeling toward medical treatment. Most of them resist psychiatric involvement because the mind is the last intact place for the spinal cord-injured patient.
- 日本心身医学会の論文
- 1991-04-01
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