喉頭部에 異常感을 호 소하는 患者의 精神科的 觀察

Psychiatric Aspects of Patients with Abnormal Sensation in the Throat

The purpose of this study is to delineate some clinical characteristics of patients complaining of abnormal sensations in their throats： both psych iatric and ENT clinical diagnoses, patterns of symptom complaints, precipitating factors, and other elinical charaeteristics were looked at. Major foci of the study was to find etiology (organic vs psychogenic) and anxiety and depression leorel in these patients acording to Zung’s Self Rating Anxiety and Depression Scale. The Subjects were 115 patients who visited ENT out patient abnormal sensations in the throat, clinic of Kyungpook University Hospital fcause of during three months from November, 1980 to February, 1981. The Study Subjects were interviewed using standard structured technic, lasting about 50 minutes. Clinical charts of ENT clinic were also reviewed. Zung’s Anxiety and Depression Scale was also applied to 184 patients who visited with the same symptoms to the ENT clinic of Kyungpook University Hospital and Kyemyung University Hospital during the month of August,1981. The results could be summarized as follows： among 115 patients 84 patients (73.4%) were diagnosed as psychogenic origin and the sex ratio being 1 :1 .7 (male 31, fem ae53). 31 pactients were determined to be organic etiology and their sex ration was 9:2. In Age distribution, organic group was somewhat older than psydugenic group, Particularly number of female patientswere over represents in organic group Psychiatric diagnoses of non-organic patients were depressive neurosis, (54%) anxiety neurosis (17%) and hysteria 7.5.%, ENT diagnoses of organic patients were chronic atropic rhinitis (42. 5 % ), acute pharyngitis (25.8% ), and others (31.7 % ). As to the duration of symptoms, 21% of psychogenic group had a history of symptoms lasting more than two years, 39% having less than three months, while the organic group 52% had a history of less than three months. A variety of symptom descriptions by the patients could be found, in both groups, but the symptoms of organic patients tended to be simpler pain-like variety. In the psychogenic group, some emotional precipitating factors were found： family dissension (27% ), physical illness other than ENT problem (23%), financial loss (19% ), death of immediate relative (10% )，etc. Finally, the mean score of Zung’s Self-Rating Anxiety Scale and Depression Scale of psychogenic group showed 48.5 and 41.1 respctively. Thesescores contrasted sharply with the scores of the organic group which were 42.3 and 46.8 respectively