Flashback現象に続いて全生活史健忘の出現をみた覚醒剤中毒の1例

Total Amnesia following Flashback Phenomenon in a Case of Methamphetamine Abuse

　【抄録】Flashback現象が全生活史健忘の出現に重要な役割を演じていたとみられる，覚醒剤中毒の精神鑑定例を報告した。症例は19歳の男性。15歳時より3年間覚醒剤を使用し，常用時には強い緊迫感とともに幻聴が出現していたが，中止後も飲酒した際に同様の異常体験が出現していた。今回，逮捕拘留中に深刻なストレスが加わり，覚醒剤常用時と同様の異常体験が再び出現したが，その後茫乎とした様子となり全生活史健忘が発症した。健忘は20日間で回復した。

　今回出現した異常体験は，過去の体験との類似性などからflashback現象によるものと考えられたが，これにより状況の認識が妄想的にゆがめられて，緊迫した恐怖体験が形成され，ヒステリー機制が発動し，全生活史健忘が発症したものと考えられた。

　We report a case of methamphetamine abuse in which flashback phenomenon played an important role to produce total amnesia.

　The patient was a 19-year-old man. He abused methamphetamine for 3 years from the age of 15 years. He experienced auditory hallucinations with a severe sense of strain when he used methamphetamine regularly. After discontinuing it, he experienced similar symptoms when he drank alcohol.

　He was under serious stress for a person of 19 years of age. After he was arrested, pathological experiences occurred again. Then he became incoherent and total amnesia developed. It needed 20 days to recover from amnesia. Since it was quite similar to his past experiences, the pathological experiences were regarded as a flashback phenomenon.

　We considered that in this case, the flashback phenomenon developed in response to his stressful situation. Then it delusively distorted recognition of the situation and resulted in a strained fearful experience. Under these circumstances, he was required to suppress such experiences, causing a hysteria mechanism to function and produce total amnesia.