精神障害を呈した慢性透析症例

A HEMODIALYSIS PATIENT WITH MENTAL DISTURBANCES, MAINLYREFUSE OF DIALYSIS: A CASE REPORT

緒言

　近年，本邦における透析療法の普及は目ざましいものがある^1，2）。これに伴う慢性透析患者の増加および長期化は精神医学的諸問題を提起してきた。今回われわれは慢性透析療法開始後3年にして透析拒否を主症状とする精神障害を呈した1症例を経験したので，本症例を紹介するとともに透析患者の精神問題について考えてみたい。

A 55-year-old housewife had been treated by hemodialysis for chronic renal failure due to polycystic kidney since August 1972. The patient lived poorly with no child. She was admitted to the Depart- After admission, she had two convulsive seizures. The diagnosis of symptomatic epilepsy was made ment of Urology, School of Medicine, Kanazawa University because of persistent gross hematuria, in June 1975.by the neuropsychiatrists. After the diagnosis, she complained of desire to death and refused dialysis. Restlessness, garrulity, sleeplessness appeared at the same time, and was referred to the Department of Neuropsychiatry.