소위 외상성신경증 환자에 대한 임상적 고찰

A CLINICAL STUDY OF TRAUMATIC NEUROSIS

Twenty cases (17 males and 3 females) of so-called traumatic neurosis discharged from neuropsychiatric ward of Kyung-Hee University hospital during the Period from Jan. 1, 1972 to Jan. 31，1976 were studied and the following results were obtained. 1. The patients were predominantly males in their twenties and thirties, were of relatively higher educational level and most of them had been employed at the time of the accidents. Their premorbid personalities were mostly immature and their premorbid social adjustments tended to be unsatisfactory. 2. The precipitating physical trauma had been mostly of minor degrees and major, extensive physical trauma resulting in gross physical disabilities did not precipitate any traumatic neurosis. 3. When classifying the cases of so-called traumatic neuroses under the classification of DSM-II, cases of unspecified neurosis with indiscrlminable mixtures of multiple symptoms of various types of neurosis were most in number followed by hystericalneurosis and anxiety neurosis. 4. The mean duration of hospitalization since the diagnoses of traumatic neurosis was 32 days which was more than twice a mean length of hospitalization of cases of all neuroses in the same ward. 5. A mean duration of hdspitalization of those with relatively immature premorbid personality and poor social adjustment was almost twice the duration of hospitalization of those with relatively mature premorbid personality and social adjustment. The group treated by regular medication and inconsistant and irregular psychotherapy had a mean duration of hospitalization that was about twice the duration of hospitalization of the group treated mainly by consistent supportive psychotherapy not relying on medication. The extent and degree of physical trauma at the timeof accident had no proportionate relationship with duration of hospitalization. 6. All the cases had been transferred from other hospitals or other department of Kyung-Hee University hospital 12 cases were from neurosurgical ward. Mean days from the date of accident to that of admission to neuropsychiatric ward was 89 days； during that period, only 2 patients had the opportunity of psychiatric interview. 7. Families of only 4 patients were relatively cooperative in the psychiatric treatment during the hospitalization. Six cases received momentary compensation during the hospitalization； twelve cases did not receive it during hospitalization. With above results, the auther attempted to review some literatures.