조울정신병의 망상과 환각의 특징

Characteristics of Delusions and Hallucinations in Manic-Depressive Illness

In this study, the author reported the various clinical characteristics of 78 patients who were diagnosed as the manic-depressive illness with psychotic features at the Neuropsychiatric Department of Korea University Hospital during the period from February, 1979 to February, 1981. This study was to investigate the frequency and characteristics of the psychotic features such as delusions and hallucinations and the clinical differences between mood congruent group and mood incongruent group of the patients with manicdepressive illness. Delusion occurred in the rate of 60.0% of the total manic patients. Among these, mood congruent delusions were seen in 40.0% and mood incongruent delusions, in 2. 0% of manic patient. Delusions occured. in 19.9% of the total depressive patients. Among these, mood congruent delusions were seen in 10.1% and mood incongruent delusions, in 9. 1% . Hallucinations were found in 18.1% of the manic and 6 . 1% of the depressive, and all the patients with hallucination also had delusions. In both the manic and the depressive, mood incongruent hallucinations occured much more frequently than mood congrunnt one. In the manic, thsre was no significant defference in sex ratio between mood congruent group and incongruent group, but in the depressive, the number of male was 2 .4 times higher than female in mood congruent group and 1.7 times higher in mood incongruent group. The mean age manic and the depressive with psychotic features at first episode were 23.1 and 24.9 years, respectively. There was a tendency to have early onset in mood incongruent group, especially in the depressive. In marital status, religious background, and family history, there were no significant differences between mood congruent group and mood incongruent group in the depressive, both. Mood incongruent group of the depressive had lower academic achievement and came from socioeconomically middle lower class than the mood congruent group, but no difference was found between two groups of the manic. In both the manic and the depressive, the history of parental loss by death, divorce or seperation before they reached the age of 13 years old, was found more frequently in mood incogruent group. In the manic, cyclothymic personality was found most frequeutly in mood congruent group and paranoid one, in mood incongruent group, whereas obsessive-compulsive personality was the common in both groups of the depressive. Psychosocial stressor as a precipitating factor were accounted for 35.0% of mood congruent group and 31.1% of mood incongruent group in the depressive. In the depressive, history of suicidal attempts were found in 41.0% of mood congruent group and 56.0% of mood incongruent group. Unexpected suicidal attempts due to hallcuination were found more frequently in mood incongruent group than mood congruent group.