精神症状を伴い, 血圧高騰と下痢を交互に繰り返した1例
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概要
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The patient was a 52-year-old male who has been suffering from periodic, alternate symptoms of elevated blood pressure during a confused state and of diarrhea during a depressive state.He had a general tendency of hypertension. When confronted with psychologically stressful situations, he tended to be confused and at the same time show extraordinarily elevated blood pressure. Then, a few days later when the blood pressure would suddenly go down, he would suffer from diarrhea for a day or two and fall into a depressive state for one or two weeks.These symptoms were repeated periodically, and often accelerated by psychological stress.Characteristic signs were revealed by psychological tests. The EEG record showed abnormal findings, and autonomic function tests (adrenaline and pilocarpine tests) showd both sympathetic and parasympathetic hyperreactions. Organic disorders, however, differentially excluded.Included among the symptoms in this case were labile type of essential hypertension, irritable colon syndrome and atypic psychosis.Judging from the association with atypic psychosis, periodicity of symptoms and EEG abnormality, it was possible to assume that endogenous disturbance of the center of autonomic nervous system might exist, even though it could not be denied that psychological stress played a certain role in making these psychosomatic and psychotic symptoms manifest. Therefore, some endoreactive mechanisum could be assumed in this case, and his somatic symptoms, i.e. extraordinarily elevated blood pressure and diarrhea, could be considered equivalent to atypic psychosis which was related to depression or epilepsy.In summary, what is suggested in this case is as follows : 1) There can be a psychosomatic syndrome which includes in itself both labile type of essential hypertension and irritable colon syndrome.2) Being equivalent to atypic psychosis, the somatic symptoms in this case (extraordinarily elevated blood pressure and diarrhea) are considered as a masked type of depression or epilepsy.
- 日本心身医学会の論文
- 1979-06-01
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- 精神症状を伴い, 血圧高騰と下痢を交互に繰り返した1例