외상성 신경증의 임상적 고찰

A CLINICAL STUDY OF HOSPITALIZED PATIENTS W ITH POSTTRAUMATIC NEUROSIS

Fifty seven inpatients diagnosed as posttrauma-tic neurosis were studied with respect to their socioeconomic status and clinical features. The results were as follows. 1) The admission rate of posttraumatic neurosis out of the total number of psychiatric inpatients was 2.8%, and this rate appeared to be increasing year by year. 2) The patients were predom inantly male (87.7%) and in the distribution of ages, most (80.7%) of them were found to be in the 20-40 year age range. 3) The incidence of posttraumatic neurosis is related to social status. Amongst 57 cases, mineworkers and the other semi-skilled workers were 63.2%. Educational level was relatively low； the group below highschool graduation was 70.2%. Most (82.4%) of th e patients were lower class in economic status. And most of the accidents occured during working. 4) The average incubation period was 51.9 days, and the cases which showed neurotic symptoms within three months after injury, were 70.2%. The longer the incubation period, the longer the average duration of hospitalization. 5) The average duration between injury and the admission to the department of neuropsychiatry was 146.9 days. Many cases (43.9%) were admitted between three months and six months after injury. Most (87%) of the patients were hospitalized at the department of neuropsychiatry within 6 months after injury. The longer this duration, the longer the average duration of hospitalization. 6) Premorbid personalities were im mature in 45.6%. The average duration of hospitalization of these cases was longer than the cases without personality disorder. 7) The diagnostic classification based on DSM-II revealed that the cases of mixed type or unspec- ified neurosis with indiscriminable mixtures of multiple symptoms of various type of neurosis were 40. 4% and the next was depressive neurosis. In the average duration of hospitalization, the above two types w ith predom inantly somatic complaints were longer than the others. 8) In the severity of injury, the cases of minor degrees were 54.6%. But in the cases of head traum a, the more severe was the injury, the longer the average duration of hospitalization. The same was true in the cases of the traum as of various other portions and they showed longer duration than the cases w ithout any injury. So to speak, the incidence rate of posttraumatic neurosis was relatively higher in the cases of minor severity and there was no significant relationship between severity of injury and that of posttraum atic symptoms. But the more severe was the injury, the longer the average durations of hospitalization. Most symptoms (58.1%) were distributed appropriately to the injured parts. These were the symptoms of central and peripheral nervous system such as the ones of head, sensory organ, and neuromuscular system. Except them, the other psychiatric symptoms were 27.0%.