慢性疼痛患者の脳神経外科学的ならびに臨床心理学検討

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Purpose : This paper aims to know whether or not neurogenic pain and psychogenic pain can be separated in the clinical entity of chronic pain. Subjects and methods : Forty patients, 16 men and 24 women with the mean age of 44-ys, sufferring from long-lasting pain were divided into 3 groups from the standpoint of existence of neurosurgical organic lesions. Group A consisted of patients with organic painful lesions, group B meant patients with organic lesions but pain provoked mainly from myofascial irritation, and group C contained patients who had no organic lesions. Group A is a neurogenic pain group; groups B and C are equal to "somatoform pain disorder" in DSM-III-R. Each group had been given the same psychological tests by a psychologist. Results : All groups showed a somewhat neurotic tendency. Group A revealed a reactive neurotic tendency, group B was fully influenced by social problems associated with the patients, and group C showed a neurotic character which had mostly acted as a factor to continue activating their pain. Conclusion : In chronic pain of any kind, both neurogenic and psychogenic mechanisms react compensatively with each other.
日本心身医学会の論文
1995-10-01