癌告知に関連して心因性嘔吐を繰り返した終末期癌患者の2例

Two Terminally Ill Cancer Patients who Developed Psychogenic Vomiting after Disclosure of Malignant Disease

　【抄録】癌告知に関連した葛藤から心因性の嘔吐を繰り返した2症例を報告した。いずれも，心理的外傷体験となる破壊的な「告知」を受けたことが契機となった。患者は病気について疑念を持ったが，周囲の告知しない方針によってコミュニケーションは途絶され，不信，疎外感を強め，身体症状が強化された。ホスピスケアにおいて環境を整え，正直な病状説明を行ったところ身体症状は軽快した。

　Two terminally ill cancer patients who developed psychogenic vomiting after disclosure of malignant disease were reported. In both cases, unexpected and sudden disclosure was the origin of the somatic symptoms. Although they suspected that they had terminal cancer, their physician and family members did not inform them of the truth. Thus, they felt isolated and distrustful, which manifested itself as somatization. Intervention to facilitate telling the truth worked effectively in palliation of their somatoform symptoms.