反復する耳痛を訴えた幼児心身症の1例

A CASE OF RECURRENT PSYCHOSOMATIC EARACHE IN A CHILD

　I．はじめに

　耳鼻咽喉科領域は，形態学的ならびに機能的に複雑かつ重要な器官を有し，また脳神経自律神経とも密接な関係にあるなど，他臓器に比し，いくつかの特殊性をみることができる。この特殊性の上に，近代生活の多様化，複雑化による心労，家庭および社会における人間関係のあつれきなどが加わり，いわゆる心身症となるケースが多い^1）。耳鼻咽喉科領域における心身症の様相は，その出現する臓器および症状など多岐多様である^2）。一方，小児においては，心と体が未分化なため，精神面の症状がむき出しに身体症状の形をとってあらわれやすく，心身症の症状も単純なものが多く早期治療が可能である。今回，筆者らは，反復する耳痛を主訴として来院した幼児の心身症例を経験したので報告する。

　A 4-year-old boy had a chief complaint of bilateral earache which paroxysmally occurred during night. After his family moved into a new house, he began to complain of bilateral earache during night. The attack gradually increased in frequency and strength, and he was referred to the Shinshu University Hospital.

　Otolaryngologically, there were no abnormal findings except hyperemia of the auricles during the attack.

　The careful psychiatric examination revealed that there were some problems in his relationship with mother. After the moving of their house, he felt terror in the new house, and complained it to his mother. Because his mother was very busy at her work, he could not be relieved from his terror by depending upon his mother. This psychological stress brought him to the attack of earache to draw his mother's attention upon him. Psychotherapy was given him togather with his mother, and one month after the therapy his attack of earache had almost disappeared.