思春期にみられる神経性頻尿 : 対人恐怖との類似について
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概要
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Nervous pollakisuria is a well-known psychosomatic disease in urological practice. Symptomatologically, the urinary frequency is not the type usually associated with urethritis or cystitis.It will cease at night and does not interfere with sleep. Also, it is often influenced by emotional changes, and relieved when the patient is at ease or interested in daily activities. Some investigators have emphasized the importance of sexual conflicts in women or obsessive traits in children. But, the reason why some persons should have such troublesome disturbances of the urinary bladder function in association with emotional conflicts is not clear.Generally speaking, the occurrence of the symptom is directly correlated to the previous experiences or illnesses of the patients. The complaints usually represent an expression of tension or anxiety, and is not due to any anatomical or physiological changes in the bladder.The anxiety of patients may not be apparently noticeable, but adequate consultation will reveal that he or she is quite concerned about the trouble and has a definite fear associated with it.It is therapeutically beneficial to detect a causative event for the development of symptoms in each subject.Clinical observation was performed on 5 adolescent cases of nervous pollakisuria. The results were as follows : 1) Nervous pollakisuria was usually intense at school, especially in classrooms, and non-existent at home. It means that the symptom is primarily influenced by emotional tension associated with life situations.2) All the cases were self-conscious and embarrassed by the presence of other people, particularly class-mates. They always felt intensive sense of shyness, self-reproach and guilt for leaving classroom for urination during school hours.3) They began to avoid their friends and school, and virtually withdraw themelves from social activities. They failed to make friends and achieve lively human relationships in their adolescent years.4) They were quite concerned about their pollakisuria and fearful of situations associated with it. They try various remedies and visit many physicians without success.5) The characteristics of their clinical features are similar in many respects to those of onthropophobia : a severe form of social phobia. They can be understood by adolescent psychology with particular emphasis on interpersonal relationship.6) We had obtained good therapeutical results by sympathetic listening followed by Morita-oriented instructions. Our main aim was to relieve fear and anxiety which are responsible for the illness. It seems important to investigate and treat pollakisuria of young generation from the standpoint of adolescent psychiatry.
- 日本心身医学会の論文
- 1987-08-01
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