단극성 및 양극성 정서질환의 망상과 환각에 대한 임상적 고찰

A Clinical Study on Delusions and Hallucinations in Both Unipolar and Bipolar A ffectve Illness

In this study, the author reported on the v arious clinical characteristics of 49 unipolar and 98 bipolar patients who were diagnosed as the manic depressive illness and visited the neuropsychiatric department o f Korea university hospital during the period from January, 1977 to February, 1980. This study was to investigate phenomenologically the frequency and characteristic nature of delusions and hallucinations seen in the above subjects. An additional attemp was made to ascertain the clinical differences between these two groups for which other authors reported. The mean age at the onset of the unipolar illness was 30.8 years old, ranging from 16 to 35 years and the mean age of the bipolar illness was 25.3 years old, ranging from 15 to 54 years. The number of females were 1.6 times greater than males in the unipolar, and 2.3 times greater in the bipolar patients. Bipolar patients had higher academic achievement than unipolar patients and both groups came from socioeconom ically upper-middle class, and no significant difference of the religious background was found between these two groups. The married were seen more, common in the unipolar than the bipolar. Depressive personality was found most frequently in the unipolar, and cyclothymic one in the bipolar. In the family history, the bipolar had more positive history of a ffective illness in the first degree relatives than the unipolar. In ordinal position o f the siblings, the greatest number was the middle born in both groups. Twelve patients of the unipolar and 21 patients of the bipolar had history of parental loss by death, divorce or separation before they reached the age of 13 years and the frequency of the loss was similar in both groups 24. in the unipolar and 21.3% in the bipolar group. The precipitating factors, such as death, loss, separation and other stressful life events were accounted for 31.3% of the total patients. Delusions occurred in the rate of 42.9% of the total patients and were seen in the rate of 66.1% of the bipolar manic and 27.8% of the depressive in both the bipolar and unipolar. A ccording to the themes of delusions, grandious natures were seen most frequently in the manic, and persecutory ones in the depressive. Among the grandious delusions, political delusions were highest in males and religious ones in females. Hallucinations occurred in the rate of 6. 1% of the total patients. Among these, auditory halluci nations w ere seen most frequently.