藥物治療 經過에 따른 꿈變形

Dream Transformation in Accordance with the Progression of Pharmacotherapy

Objects ： The purpose of this study was to investigate the transformation of dreams in terms o f its therapeutic significance in accordance w ith clinical im provem ent by pharmacotherapy. Methods : Materials were 160 dreams of the 80 neurotics and psychotics among 132 cases w ho had been treated w ith pharmacotherapy at the psychiatric departments o f 4 hospitals, located in the city o f Pusan. Subjects were instructed to write their dreams before and after clinical im provem ent. The severity o f clinical symptoms was measured by standardized Sym ptom Checklist-90 -Revision and the criteria o f clinical im provem ent was 20% o f im provem ent. The m ethod o f dream analysis used the functional scoring system that had been designed by Correire et al, subsum ing process scales and content scales. In process scales, feeling intensity, dreamer activity, dream clarity, and dreamer expression were assessed w ith the means and standard deviations o f rating in each scale. As content scales, origin o f feeling, dream setting, age o f dreamer, dream charatcters, and overall rating were evaluated w ith the percentage o f dreams in each category of scales. Results : Average feeling intensity was reduced with the progression of pharmacotherapy without statistical significance between before - and after - improvement phases. The dreamer activity and dream clarity was also reduced with the progression of pharmacotherapy with out statistical significances. But dreamer expression was reduced with the progression of pharm acotherapy w ith statistical significance(p< 0.05). The proportion of symbolic dreams increased as pharm acotherpay progressed, whereas that of real dreams decreased, but there were no statistical significances. Dreams that w ould make clear reference to dream ers personal present life, dream characters that dreamer personally knows, and the origin of feeling which are evidently about people or events in dreamer s present situations decreased in proportion with out statistical significances as pharmacotherapy continued. However, the proportions of each classification in the age of dreamer showed little changes with the progression of pharmacotherapy. Conclusion : The above findings indicate that the transformation of dreams does not occur in terms of its therapeutic significance in accordance with clinical improvement by pharm acotherapy except dreamer expression. In addition, those findings are contrary to the results of various studies on the transform ation of dreams in accordance with the progression of psychotherapy. In case of psychotherpay, feeling intensity, dreamer activity and expression, dream clarity, and real dreams significantly increased as psychotherapy progressed. It supports conventional understanding that two modalities of pharmacotherapy and psychotherapy act on different foci of a patients problem . Accordingly, it suggests that pharmacotherapy and psychotherapy should not becom peting to each other, but complementary.