| 特集名 | 心身症と消化器疾患 | |
|---|---|---|
| 題名 | 消化性潰瘍とうつ病 --症候移動の視点から | |
| 発刊年月 | 1998年 11月 | |
| 著者 | 中山 道規 | 防衛医科大学校精神科 |
| 著者 | 土居 通哉 | 防衛医科大学校精神科 |
| 【 要旨 】 | 消化性潰瘍の経過中またはそれに直接継起してみられた15例のうつ病について検討し，以下の特徴とその臨床的意義を指摘した． 1）うつ病と潰瘍の発現時期の関係から，これらの症例はpost-u1cerative depressionと範疇化できる． 2）うつ病はほぼ典型的な内因性病像を呈し，病前性格はおおむねメランコリー親和型であった． 3）うつ病の抗うつ薬への反応は悪く，遷延化・難治化・慢性化の傾向を示すが，結果的には寛解に至る．長期的予後すなわち感情障害の亜型としては，単発単相型うつ病に親和性があると推測される． 4）この症例群はGroenのsomatopsychic syndrome shift概念で厳密に把握するよりも，合併・併存でみるほうが実際的である． |
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| Theme | Gastorointestinal Diseases --from the Standpoint of Psychosomatic Medicine | |
|---|---|---|
| Title | Depressive Patients Associated with Peptic Ulcer -- from the Standpoint of Syndrome Shift (Groen,J.J.) | |
| Author | Michinori Nakayama | Department of Psychiatry, National Defense Medical College |
| Author | Michiya Doi | Department of Psychiatry, National Defense Medical College |
| [ Summary ] | The authors retrospectively investigated the clinical features of 15 depressive patients and their association with peptic ulcers. Depression begins either in the course of treatment or immediately after the healing of peptic ulcer. These cases are categorized as post-ulcerative depression, that is seen as one of the refractory or therapy-resistant subtypes of depression. Post-ulcerative depression often manifests itself as monopolar depression rather than the recurrent types of depression, such as bipolar or unipolar. Substitution of peptic ulcers for depression in these patients might be perceived as a sort of somatopsychic syndrome shift (Groen,J.J.), but it is more practical to see it merely as an association of the two syndromes, brought about partly due to certain iatrogenic factors. | |