간질성 정신병의 임상적 연구

A Clinical Study of Psychoses in Epilepsy

A clinical study of psychoses in epilepsy was performed on 352 patients with epilepsy, who visited at Neuropsychiatry Department, Pusan Paik Hospital, In - Je medical college, from January 1982 to December 1984 for 3 years. Among the patients, 23 cases (6.5% ) manifested psychotic states. The psychotic states could be classified into the following 5 types ; Schizophrenia like state, Delusional - hallucinatory state, Paranoid state, Manic depressive state, Transient psychotic state. Two cases showed schizophrenia like state which was difficult to differentiate from schizophrenia. There were 12 cases( 52.5%) of delusional — hallucinatory state, 4 cases( 17.4% ) of paranoid state, 3 cases ( 13%} of manic depressive state, and 2 cases ( 8.7%) of transient psychotic state. Some clinical factors appeared to correiate closely with the psychotic state. O f the cases with delusional - hallucinatory state, 58% had complex partial seizure and showed temporal spike foci on electroencephalography. However, in the other types o£ psychoses, there were no significant findings in clinico - electroencephalographic aspect In 14 cases of the subjects, obvious adhesive personality trait was found, particularly in paranoid state and delusional - hallucinatory state, all of the cases showed the trait and their ability of adaptation t6 environment was disturbed apparently by the trait. In 13 cases, on the other hand, some psychological precipitating factors were found at onset of the psychotic states. The authors concluded that there were different types of the psychotic state in so - called epileptic psychosis, and there appeared to be different clinical factors, probably relating to occurrence ᄋ£ the psychotic state. Importance of adhesive personality trait and psychological factors at onset was stressed in the psychosis.