판탐지현상의 임상적 및 정신의학적 특성

Clinical and Psychiatric Characteristics of Phantom Limb Phenomenon

Objects : Phantom lim b phenomenon(PLP) is characterized by a sensation o f persistence o f the lim b even after its removal. Limb amputation itself give rise to serious functional, social and psychological problems. The aim o f this study was to evaluate clinical and psychiatric characteristics o f PLP. Methods : This was a prospective study o f 32 patients who had undergone lim b amputation due to traumatic injuries and physical diseases. The researchers had semi-structured interview with patients at 3 days, 7 days and 30 days after operation in order to obtain information about PLP and its related clinical characteristics. A t the same time self-rating scales for state anxiety(Spielberger et al 1970), depression (Beck 1961) and pain and distress(Zung 1983) were administered to patients and then these psychopathological states were compared between groups o f patients [patients with PLP vs. those without PLP(APLP) and patients with painfiil PLP(P-PLP) vs. those with non-painful PLP(N-PLP)]. Results ： 1) Among 32 amputees, 27(84%) experienced PLP. 26(96%) cases out of these appeared w ithin 3 days after amputation. In 17(70%) cases the PLP lasted till the time o f the 30th day after amputation. The incidences o f feeling o f movement, telescopy, appearance o f dream and pain in the PLP group were 18(66%), 11(40%), 6(22%) and 20(74%) respectively. 2) O f 20 patients with P-PLP, 14(70%) cases experienced the pain within 3 days after amputation. In 13(65%) cases the pain lasted till the time o f the 30th day after amputation. 3) The types of phantom pain varied considerably among amputees. However, electric current sensation was most commonly reported after amputation. Phantom pain was often aggravated by touch or approach o f stump but, relieved by distraction. 4) The scores o f rating scales for anxiety, depression and pain and distress were significantly higher in PLP group than APLP group and also significantly higher in P-PLP group than NPLP group. Conclusions : The incidence o f PLP and its related clinical characteristics are similar to the studies reported by others. The psychopathological states o f the amputees suggest that psychiatric intervention is required particularly for those with PLP but more for those with PPLP.