高齢者の口腔内セネストパチー―20症例の後方視的調査

Oral Cenesthopathy in the Elderly: A retrospective case series

抄録

　目的　高齢者の口腔内セネストパチーの臨床的特徴を明らかにする。

　方法　入院患者を対象にカルテ調査を行い，後方視的に20例の口腔内セネストパチーの症例を特定した。基本的属性，診断，転帰，有効な治療法，認知機能，検査所見などを調査した。

　結果　平均年齢は75.65±5.49歳，男性4名女性16名だった。診断は気分障害圏が75%を占めた。転帰は寛解9例，軽快8例，不変3例だった。5例が抗精神病薬，5例が電気けいれん療法，4例が抗うつ薬で良好な転機に至った。

　結論　高齢者の口腔内セネストパチーは，気分障害圏が多く，転帰が比較的良好であり，電気けいれん療法が有力な治療選択肢である。

　Context　Cenesthopathy is a term that describes an aberrant bodily sensation in mental disorders. Oral cenesthopathy is a relatively common symptom encountered in clinical practice, but remains poorly understood.

Objective　To describe the clinical characteristics of oral cenesthopathy in the elderly.

Methods　We conducted a retrospective investigation of the medical records of patients who were hospitalized in the psychiatric ward of general hospital for the elderly in Japan from 2005 to 2010. Twenty cases (4 men, 16 women) of oral cenesthopathy were identified.

Results　The mean age of the patients was 75.65±5.49 years. Seventy-five percent of the patients met the ICD-10 diagnostic criteria for affective disorder. Among the 20 patients with oral cenesthopathy, 9 were in remission, 8 showed improvement and 3 were unchanged. The therapeutic modalities that were found to be effective were antipsychotics (5 cases), electroconvulsive therapy (5 cases), and antidepressants (4 cases).

Conclusion　Oral cenesthopathy in the elderly is most often manifested as a symptom of affective disorder and has a relatively good prognosis. Electroconvulsive therapy is a potentially effective treatment option.