정신분열병 환자의 환시에 관한 임상적 연구

Visual Hallucinations in Schizophrenic Patients

Objective：The purpose of this study was to investigate actual visual hallucinations as perceived by 40 schizophrenic patients and, subsequently, to explore their psychopathology in order to assist clinicians in more effectively evaluating and treating the visual hallucination. Methods：With the authors’ guidance, the content and meaning of pictures drawn, according to their perceptions, by 40 schizophrenic patients were evaluated in conjuction with an examination of the patient s emotional reaction and associated behavior. The results from the visual hallucination group were analyzed and then compared with non-visual hallucinatory control group using the Brief Psychiatric Rating Scale(BPRS). On this basis, the authors investigated the correlations between patients’ strength of confidence in visual hallucination, frequency of visual hallucination, mean duration of an episode and the score of BPRS, and the correlation between meaning of visual hallucination and the type of patient s delusion. Finally the authors attempted to derive correlation among the items of BPRS. Results： 1) The content of visual hallucination was mostly non-human and mythologically exhibiting anthropomorphic qualities while its meaning was frequently persecutory. In addition, the visual hallucinations experienced by the subjects were most often close to or within the patients’ ordinary visual range with mean duration of halluinatory episodes ranging from 1 to 5 minutes. The most frequent reaction of patients is a negative emotional response and the most frequent overt behavior was either verbal or restricted physical activity. 2) There was a positive correlation between the meaning of the visual hallucination and the type of patients’ delusion. 3) The group having visual hallucinations had more frequent anxiety, hallucinatory behavior and unusual thought content compared to the non-visual hallucination group. 4) There were positive correlations between patients’ strength of confidence in visual hallucination and hallucinatory behavior and among anxiety, tension, motor retardation and mean duration of episodes of visual hallucination. 5) There were positive correlations between hallucinatory behavior and anxiety, hallucinatory behavior and mannerism and posturing, hallucinatory behavior and excitment, and hallucinatory behavior and motor retardation. Also, there were positive correlations between motor retardation and tension, blunted affect and tension, and between emotional withdrawal and tension among each item of BPRS in the visual hallucination group. Conclusion：In this study of visual hallucinations in schizophrenics, the authors concluded that it is helpful for clinicians to evaluate how schizophrenic patients experience their visual hallucination.