히스테리 신경증과 과거 16년간의 증상양상의 변화에 관한 연구

HYSTERICAL NEUROSIS AND THE CHANGES IN ITS SYMPTOM PATTERN FOR LAST 16 YEARS

A clinical study, reviewing the chart of 159 inpatients suffering from hysterical neurosis in Yonsei Medical Center during two periods, 1959 to 1962 and 1976 to 1978, was conducted to study the characteristic clinical feature of hysteria and the change in its prevalence and in the pattern of conversion symptoms for last 16 years between the two periods. The results revealed； 1. The frequency of the hysterical neurosis was not changed between two periods. E ighty three of them were females, but numbers of males were increasing. Most patients were in their 20s and 30s and the ir average age of onset was becoming younger (table I ) . 2. Generalized convulsion was the most frequent chief complaint. Others were paralysis, paresthesia, headache, dyspnea, pain and G-I troubles. The dissociation smyptoms were rare. No significant change was noted in the pattern of the chief complaints for the past 16 years (Table 2). 3. In average, a patient complained 4 to 5 conversion symptoms. The females complained more than the males did. The average number of symptoms was increasing. Pain was the most frequently complained symptom, and also the symptoms of autonomic nervous system, especially gastrointestinal symptoms, were increasing. So it can be reasonably stated that the classical form of hysterical symptom is declining. The males complained more of paralysis and dizziness, while the females complained more of pain, fainting, globus hystericus, aphonia and itching sensation of sex organs. 4. In many patients, other neurotic symptoms such as anxiety, depression, hypochondria or fear were combined, but la belle indifference. was rather URCommon. Regarding to In premcrbid personality, hysterical personality was most common and also found were obsessivecompulsive and schizoid ones. The most common precipitating factor was considered to be sexual problems and also included were the conflicts with motherin-law and other life stresses. Conflicts with mother in law, financial failure, and； failure in college mtrance examination were seemingly increasing in number as a precipitating stress in the recent years, w hich was to reflect the recent changes, in social valuse system. 5. It was noted that there was some symbolic correlations between the particular somatic symptoms and the co-existing psychological symptoms, premorbid personality and the precipitating factors, suggesting some dynamic processes invplved in patient’s selecting of conversion symptom.