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Seishin Igaku Volume 26, Issue 9 （September 1984）

精神医学 26巻9号（1984年9月発行）

Japanese English

研究と報告

進行性全身性硬化症（PSS）にみられた神経精神医学的所見についての検討 A Neuropsychiatric Study on Patients with Progressive Systemic Sclerosis 山下元基 ¹ , 武田憲明 ¹ , 白河裕志 ¹ , 植木啓文 ¹ , 森清幹也 ¹ , 森俊二 ² , 前田学 ² , 森也寸志 ² , 貝谷壽宣 ¹ Motoki Yamashita ¹ , Noriaki Takeda ¹ , Hiroshi Shirakawa ¹ , Hirofumi Ueki ¹ , Mikiya Morikiyo ¹ , Shunji Mori ² , Manabu Maeda ² , Yasushi Mori ² , Hisanobu Kaiya ¹ ¹岐阜大学医学部神経精神医学教室 ²岐阜大学医学部皮膚科学教室 ¹Department of Neuropsychiatry, Gifu University School of Medicine ²Department of Dermatology, Gifu University School of Medicine キーワード： PSS , Psychotic symptoms , EEG findings Keyword: PSS , Psychotic symptoms , EEG findings pp.947-953

発行日 1984年9月15日 Published Date 1984/9/15

DOI https://doi.org/10.11477/mf.1405203819

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Abstract 文献概要
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　抄録　PSS患者20名を対象として同疾患における精神神経症状を検討した。

　著明な精神症状を示したのは2例で，その症状の基底に意識障害の存在が疑われ，症状精神病の病像を呈した。1例は尿毒症であったが，血清尿素窒素（BUN）が減少した後も錯乱状態はしだいに悪化し，数週間後に脳出血にて死亡した。他の1例は躁状態を呈したが，約半年後に精神症状は軽快した。また，その他多くの患者は神経症性の不安・抑うつ状態を呈した。脳波所見は16例中7例に異常が認められ，そのうち6例が徐波化であった。また，心理検査にても軽度知能低下傾向，特に抽象的問題解決能力低下傾向が示された。

　以上精神医学的検索から，PSSに際しみられる精神症状は，中枢神経系のびまん性の器質性障害が基盤となり，更に，患者の病前性格や難病に対する心理的反応が加わり，発症するものと考えられた。

　Twenty patients with progressive systemic sclerosis (PSS) were examined from a neuropsychiatric point of view. The ages of the subjects ranged from 18 to 65 years old. All subjects were female except one. Mean duration of illness was 7.8 years (1-15 years). Two patients with PSS showed remarkable psychiatric symptoms, regarded as symptomatic psychosis. One of the patients with uremia showed a confused state even after a decrease in BUN level, during which steroid therapy had been interrupted. In the other case a manic state was observed for about 6 months. Most of the patients without prominent psychotic symptoms were apt to have neurotic depression. The electroencephalographic examination revealed abnormal findings in 7 of 16 patients, consisting of diffuse slowing of basic activity and theta burst. No particular abnormalities were demonstrated when examined by computed craniotomograpy in 6 cases. Six randomely selected patients were subjected to an intelligence test (Wechsler adult intelligence score), which showed normal abilities in the problem of information and comprehension, and low ability in the problem of similarities. Four out of 5 patients who underwent a memory test showed normal scores in the relatedpair words problem and very low scores in the non-related pair words problem. All these results obtained from psychological tests suggest that patients with PSS have initial signs of an organic brain disorder.

　Mental symptoms seen in patients with PSS seem to occur through some diffuse organic disturbances in the brain. In addition, psychological stress inresponse to serious disease will play some roles in the development.