フェティシズムを呈した特発性副甲状腺機能低下症の1例

A Case of Idiopathic Hypoparathyroidism with Fetishism

　抄録　フェティシズムを呈した特発性副甲状腺機能低下症の1例について報告した。症例は，30歳の男子。10歳時からおしめを盗んでは自慰にふけるようになり，次第に女性の下着も盗み始め，17歳時からはもっぱら女性の下着を盗んでは，それを身につけて自慰をし，性欲を満たしていた。身体的には，4歳まで歩行不能。8歳まで夜尿症のためおしめをしていた。17歳時からけいれん発作が出現し，抗てんかん薬で改善しなかった。24歳時に特発性副甲状腺機能低下症と診断され，ビタミンDやカルシウム等の服薬でけいれん発作は消失した。しかし，フェティシズムについてはなんら改善は見られなかった。

　本症例のフェティシズムの成立には，身体的要因ならびに心理社会的要因が密接に関連していた。すなわち，副甲状腺機能低下症による身体的諸症状は，両親の不和という状況下で母親の溺愛を招き，それはさらに，対人関係の発達を障害し，社会的適応を困難にした。特に，8歳時までしていたおむつが，父母離婚で，不安が高まった時に，移行対象的性質を持ち，本症例のフェティシズムの成立に大きな役割を果たしていたと考えられる。

　We report a case of idiopathic hypoparathyroidism with fetishism. The case is a 30 year old male. He started to steal diapers and masturbate from 10 years of age. Gradually he progressed to stealing women's underclothes too. Since he was 17 years old, he has stolen only woman's underclothes. He wears them and masturbates to satisfy his sexual desire.

　As to his physical problem he could not walk until he was 4 years old. And he had worn a diaper until 8 years of age for his enuresis. From 17 years of age he suffered from convulsions, but antiepileptic drugs were ineffectial for his fits. At 24 years old he was properly diagnosed as idiopathic hypoparathyroidism and his fits disappeared by taking calcium, vitamin D and other drugs. But his fetishism did not disappear and continued.

　The formation of his fetishism can be attributed to psychosocial and physical factors, the physical dominating influence on the subject's development. His physical disability resulted in maternal overindulgence under the parental discord. This, in turn, restricted the development of interpersonal relationships essential to social adjustment. We think particular attention should be given to the diapers which were worn until the subject was 8 years old. It is felt they had the characteristics of a transitional object when he missed her mother after parent's divorce and considerably influenced the formation of his fetishism.