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靑年期 頭部 體感症(Cenesthopathies)의 臨床的 考察
서울 고려병원 신경정신의학 대한신경정신의학회 1986 신경정신의학 Vol.25 No.4
The term, cenesthopathies, was first introduced by Dupre E. and Camus P. in 1907 as one of the distinctive syndrome, that consists of; 1) strange body sensation, cenesthasie, 2) undefined, foreign body like sensation, 3) troubled with suffering rather than actual pain, 4) fixed location with clear demarcation and jpersistency, 5) differs from hyochondriasis, 6) may be constitutional factor as an etiology. The author has experienced 17 cases of cenesthopathies in the past three years at Seoul Koryo General Hospital. Clinical finddings of six cases, whose onset was before the agd of 30’s and the symptom site is limited to the head, will be discussed. summary: 1) All six cases were male with average age of onset 22.5 (18 to 29) and four of them were the first boms. 2) No significant family history is noted. 3) As of the premorbid personality, traits of being obsessive, timed and insecure are noted. 4) The way they descrive the body sensation is very strange and odd indeed. Their description is something like net, liquid, ligament, brain, band and also like a vaccum or empty space in two cases. Despite of their efforts to describe as accurately as possible, they are unable to define clearly. 5) The location is always fixed and well demarcated, no matter how long they suffer from it. 6) As the sensation moves along the fixed passage, there is a state of tension and relaxation alternating. This brings the mental changes as follows; tension, by “covered by net” or “filled with liqukJ”, leads to mental block, then the felling of depersonalization follows. Subsequently, relaxation period ensues with cleaning off the covered net or emptying the filled liquid, then the mental work becomes possible. 7) They are more troubled by suffering and bewidderment rather than actual pain. 8) the precipitating event is identified in all of the cases. All of them were under the heavy strain to achieve higher goal, eg, college entrance examination. 9) It differs from hypochondriasis and schizophrenia and the patients show no other no other si^is of mental illness. 10) Therapeutic results are rather unsatisfactory; open trial of pimozide seems mildly effective in lessening the intensity of symptomatic complains, and dynamic psychotherapy is also definitely recommended. 11) Thou삶! the symptom waxes and wanes and the course is chronic in nature, their soda! productivity has been fairiy well preserved, despite of agony and difficulty they encounter. 12) As to diagnosis, no agreement has yet been reached, however, author’s impression is that it is discrete syndroms, if not an independent disease entity.
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