産業炎害患者의 精神醫學的 問題

Psychiatric Problems in the Victims of Industrial Accident

For the purpose of understanding psychiatric problems in the victims of industrial accident, MMPI as a screening test was performed by 182 inpatients in Industrial Rehabilitation Center in April 1981, and three case histories were reported， along with a discussion on sociocultural factors. By MMPI response it was noted that; (1) Among 172 valid respondents, 1-4/4-1 code type was found in 29 patients, 1-8/8-1 code type in 20 patients, 1-3/3-1 code type in 18 patients. Code type incidence suggests that major personalitycharacteristic of respondents is hypochondriacal, pessimistic, grouchy, socially inadequate, isolated in interpersonal relationship and tends to somatize. (2) Diagnostic profiles by MMPI were revealed as the following； neurotic profile in 77 patients, psychotic 46 personality disorder 25 and normal 24. Thus the seriousness of psychiatric problems was indicated. (3) Total mean score of each MMPI scale revealed elevation of Hs, Pd, and Hy scale. (4) Diagnostic profiles by MM PI were significantly related to eduction and economic concern and were probably related to the marital status and the type of physical injury. (5) Most of patients viewed their accident occurred mainly due to someone else’s fault and poor working conditions. Through above MMPI results and case reports, the author pointed out some socioeconomic problems which might contribute to the psychiatric problems of industrially injured patients as the following; Firstly, The limitation of compensation for psychiatric problems in Korean Compensation Law for the Victims of Industrial Accident and another compensation, ie compromise between company and patient behind the scene should be corrected and supplemented. Secondly, in couducting psychotherapy to the industrially injured patients one should understand of its psychology from socioeconomically low class. Thirdly, the negative influence of iatrogenic factors upon accident process should be decreased. Lastly, There is poor contribution of psychiatrists to rehalilitation process. It is desirable that psychiatrists should play a role in leading doctor-patient relationship based upon the wholeman concept which emphasizes dynamic understanding of the patient’s physical, psychological and socioeconomic status.