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Seishin Igaku Volume 51, Issue 8 （August 2009）

精神医学 51巻8号（2009年8月発行）

Japanese English

研究と報告

気分障害患者とパーソナリティ障害患者における過量服薬の臨床的特徴の相違―自殺意図・抑うつ・解離に注目して Clinical Differences in the Extent of Suicide Intent, Depression, and Dissociation between Self-poisoning Patients with Mood Disorder and those with Personality Disorder 安藤俊太郎 ^1,2 , 松本俊彦 ² , 重家里映 ¹ , 北条彩 ¹ , 島田隆史 ³ , 中野谷貴子 ¹ , 安来大輔 ¹ , 京野穂集 ¹ , 西村隆夫 ¹ Shuntaro ANDO ^1,2 , Toshihiko MATSUMOTO ² , Rie OMOYA ¹ , Aya HOJO ¹ , Takafumi SHIMADA ³ , Takako NAKANOTANI ¹ , Daisuke YASUGI ¹ , Hotsumi KYONO ¹ , Takao NISHIMURA ¹ ¹東京都立府中病院精神神経科 ²国立精神・神経センター精神保健研究所自殺予防総合対策センター ³国立成育医療センター神経内科 ¹Department of Psychiatry, Tokyo Metropolitan Fuchu Hospital, Fuchu, Japan ²Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry ³Division of Neurology, National Center for Child Health and Development キーワード： Self-poisoning , Depression , Dissociation , Mood disorder , Personality disorder Keyword: Self-poisoning , Depression , Dissociation , Mood disorder , Personality disorder pp.749-759

発行日 2009年8月15日 Published Date 2009/8/15

DOI https://doi.org/10.11477/mf.1405101466

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抄録

　本研究では，過量服薬患者の臨床的特徴を明らかにするために，気分障害とパーソナリティ障害との間で，自殺意図の重症度，抑うつや解離に関する比較を行った。対象は，救命救急センターに過量服薬のため入院し，ICD-10で気分障害またはパーソナリティ障害と診断された32名である(気分障害20名，パーソナリティ障害12名)。自記式質問票による調査の結果，両群間に自殺意図の重症度に有意な差を認めなかった。また，両群ともに顕著な抑うつ，解離傾向を認めたが，その程度に有意差は認めなかった。以上により，パーソナリティ障害における過量服薬は，気分障害と同程度に深刻な抑うつや解離傾向を伴っている可能性が示唆された。

　Objective：To clarify the psychopathological differences between self-poisoning patients with mood disorder and those with personality disorder.

　Methods：Of the 73 patients who were admitted to an emergency department between March and July 2008 for self-poisoning, we selected 32 (25 women, 7 men；average age 31.2±8.9 years) who met the ICD-10 criteria for either mood disorders (F3：mood disorder group) or disorders of adult personality and behavior (F6：personality disorder group). The shortened version of Beck's Suicide Intent Scale (SIS), the K10 Anxiety and Depression Test, and the Adolescent Dissociative Experience Scale (ADES) were administered during the course of the clinical interview.

　Results：Among the items included in the SIS, only one-reaction to the act-demonstrated a significant difference between the 2 groups. Specifically, patients in the mood disorder group were more likely to feel disappointed about having recovered from a comatose state than those in the personality disorder group. No significant differences were detected between the 2 groups with respect to the results of the K10 test and the ADES；both groups exhibited high total scores of both tests (K10：mood disorder group, 33.1±9.5；personality disorder group, 33.4±9.4 and ADES：mood disorder group, 3.6±2.3；personality disorder group, 4.1±2.0). These findings indicated that there were no significant differences between the 2 groups in terms of intensity of suicidal intention and severity of depression and/or dissociation.

　Conclusion：Our results indicate that personality disorder patients may attempt self-poisoning with nearly the same levels of suicidal intention and severity of depression and dissociation exhibited by mood disorder who attempt.