[原著］高齢者の身体障害感について
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概要
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1. Somatic complaints in the aged must be intaked carefully. Signs and symptoms of somatic disease in the aged are more atypical than in the adult, and special deliberation must be given for correct diagnosis. Even if somatic functional complaints are due to psychiatric problems, all of them are not psychological; there are, supposed, morphological or functional changes due to ageing. Signs and symptoms are subtly affected by psychological and environmental conditions. 2. The author made a study on the psychological, familial and social background of aged people who were prone to complain somatic complaints. 3. Subjects were 125 aged people who were over 60 years old and supposed to adapt themselves to social living. They were investgated by a questionnaire. The subjects were divided into two groups; 56 subjectively healthy group (HG) and 69 subjectively unhealthy group (UHG). The two groups were compared each other. UHG members reported that they had hypertension, heart disease, neulalgia, reumatoid arthritis, and GI disease, which supposed to rather relate to ageing process and not to be fatal. 4. The results were as follows. (1) As to partner's condition, most of HG had also healthy partners. Especially, the male aged showed the characteristic. About a third of female UHG were living alone. (2) As to the question whether it was comfortable or not to live at home, most of HG answered that they did something quite naturally and freely, and were pleasant. Members of UHG answered that they seldom did freely, felt constrained, were unpleasant because of duties of household affairs, and were living very lonely on account of being rejected by their families. A few members of UHG reported that they wanted to live with another daughter or son, or to live alone. 5. The author's discussion based on the results the references and the author's experience of psychoanalytic psychotherapy for the aged, was made on the self-image, the feeling of bodily impairment and the sense of health in the aged. Adding to these, next two points were discussed. The feeling of bodily impairment was controlled by a subtle psychological interaction of the couple which was acquired through marital relationship, and which was correlated to the quality of working through internal object introjected in early infancy. As to loneliness of aged people, there is a psychological mechanism which compelled them to bo lonesome and which supposed to correlate to the quality of narcissism which has been changing through longtime from early infancy.
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