내과에서 의뢰된 신체화 환자와 정신과로 직접 내원한 환자의 호소에 관한 임상적 고찰

A Clinical Study on the Complaints between Referred Somatizers from Medical Department and Directly Visiting Ones to Psychiatric Department

This study was conducted to compare the somatic complaints between referred somatizers from medical department and directly visiting ones to psychiatric department Inchon Christian Hospital from March 1989 to February 1990. All complaints were recorded according to the patients verbal expressions at the initial interview. The results were as follows * 1) The diagnoses of all patients were somatoform disorder(58.7%), anxiety disorder(28.5 % ) and depressive disorder(12.8%). 2) Female patients were referred and visited directly more than male patients, 83.7% of all referred patients and 68.9% of all directly visiting ones respectively. 3) The mean ages of referred patients were higher than those of directly visiting ones, and the referred female patients were significantly older than the directly visiting female ones. 4) Somatoform patients of the referred group were significantly more included to the older age group than 45 years of age. 5) The referred group had many complaints of abdomen, chest and head in order, but the directly visiting one had many complaints of head, abdomen, and chest in order. Particularly the referred patients had significantly more complaints of abdomen than the directly visiting ones. 6) The referred patients of somatoform disorder had more complaints of abdomen than the directly visiting ones, and directly visiting patients of anxiety disorder had more complaints of sleep and dream than the referred. 7) Each patient of the directly visiting group had average 4.7 somatic complaints and one of the referred group had average 5.9 complaints. But the psychic complaints of somatoform and anxiety disorders of the directly visiting somatizers were significantly more than those of the referred. These results were suggested that older female somatoform patients were referred from medical department and they wanted to visit medical department due to their somatic complaints. But younger male patients had the tendency to visit directly the psychiatric department. The referred patients from medical department had the more somatic complaints of abdomen and chest and the directly visiting patients to psychiatric department had the more complaints of head and abdomen. These findings will be discussed to find the symbolic meanings of those organs.