強迫的収集癖を主症状とした5歳児の1例

A Case Report of a 5 Years Old Boy who Had a Compulsive Collecting Mania as Chief Complaint

　抄録　精神科において強迫症状を呈する幼児を診ることは少ない。また文献を調べた限りでは，その詳細な症例報告も少ない。

　我々は強迫的収集癖を主症状とし，多彩で重篤な強迫症状を認めた5歳男児を経験した。本例はほぼ最少年齢発症と位置づけられるが，強迫症状に対する抵抗の感情を初めとして大人の強迫症状と類似していた。発症要因として母の強迫性格の影響と，本児の不均衡な発達が重要と思われた。治療として従来の遊戯を含めた面接，母へのカウンセリングに加え，症状の激しさから行動療法（断行訓練），薬物療法（抗不安薬）を含めた多角的治療を要した。治療の結果強迫症状の軽減をみたが，今後も治療的かかわりを要すると思われた。

　In clinical psychiatry, we rarely meet obsessive compulsive disorder (OCD) in infancy. Looking over the literature, we see few case reports describing such infant OCD in detail.

　We encountered a 5 years old boy who had compulsive collecting mania as his chief complaint, as well as other various compulsive behaviors. We can say that he was one of the youngest ever found to suffer from OCD. But his OCD resembled what was seen in adulthood because the compulsion was accompanied with emotional struggle. We found that his mother had an obsessional personality. We regard this fact as an important indicator of the cause of his OCD, because his psychological development was unbalanced. (He was as bright as average, but his peer relationships were immature.) We treated him with play therapy, and we councelled his mother as usual. But, as his disorder was so heavy, we also needed to use behavior therapy (assertive training) and medication (minor tranquilizers). One year later, he was almost healed, but we thought that a longer intervention would be needed because he still had problems with peer relationships.

　We reported this case in detail, and added some considerations about OCD in infancy.