外傷後神經症에 관한 臨床的 考察

Clinical Aspects of Post-traumatic Neuroses

The purpose of this study is to delineate some clinical characteristics of post-traumatic or accident neuroses； family and economical back ground, clinical symptom atology and diagnosis, and problems surrounding compensation. The authors collected the clinical records of 99 post-traumatic psychiatric inpatients and outpatients at Kyungpook and Kyemyung University Hospitals and three other private psychiatric clinics at Daegu area, during a period of two years from January 1st, 1979 to December 31, 1980. Out of the 99 post-traumatic cases, 19 cases with organic brain syndromes were excluded in the present study. Of all the 80 cases, 38 cases were interviewed by the authors and 42 by other psychiatrists. The results obtained could be summarized as follow s； Of all the 80 post-traumatic cases, the number of male patients was 51 and that of female was 29, the male to female sex ratio being 1 .8 ： 1. Slightly over half of them were in their thirties and forties. The educational level o f about two thirds of the patients was below middle school. 16% of them were unemployed, and 25% laborers. And majority of them belonged to low social classes. In the psychiatric interview, they showed a variety of difficulties； financial difficulties (25%), interpersonal conflicts (18% ), vocational dissatisfaction (9% ), and other physical illnesses (4% ). Most frequent symptoms o f the post-traumatic neurotics were headache (78% ), insomnia (43%), dizziness (34%), mem ory loss (29%), anxiety (25%) and loss of interest (25%). As to the clinical diagnostic classification (ICD- 9), 55% was diagnosed as hysteria, 19% as anxiety neurosis, 14% as neurotic depression, 6% as hypochondriasis and 2% as phobic neurosis. The average period of hospitalization was 50.3 days, and the duration from the time of trauma to the first psychiatric visit was 35.5 days in； average. Finally, the authors had the impression that the course of post-traumatic neuroses was much influenced by the attitudes of the offenders and the court process o f the compensation itself.