著者
大塚 耕太郎 酒井 明夫 浅利 宏英
出版者
日本医学哲学・倫理学会
雑誌
医学哲学 医学倫理 (ISSN:02896427)
巻号頁・発行日
vol.18, pp.55-65, 2000-12-15 (Released:2018-02-01)

Two cases of schizophrenia (A : paranoid type, B : residual type according to the ICD-10 criteria) were studied, both of which were referred from a psychiatric hospital to the surgical and psychiatric departments of a University Hospital for the treatment of physical complications. Both patients were diagnosed with cancer and surgical treatment was recommended. Although case A underwent surgery along with the full informed consent requirement, case B was treated through proxy consent by her family due to impaired capacity. The difference in competence between these patients seemed to be related to their negative symptoms, for example apaty, abulia, withdrawal, and slowed thought of case B was more severe. In addition, this case study revealed that "reduction of restriction produced by phenomenological disturbances in subjective time in chronic disease" and "coordination of medico-cultural differences between psychiatry and other medical specialties" are necessary to improve the QOL of schizophrenic patients with physical complications. It is suggested that consultation-liaison psychiatry in a broad sense, including sufficient aspects of bioethics and philosophy of medicine, would be useful for the treatment of physical complications of psychiatric patients.
著者
大塚 耕太郎 鈴木 友理子 藤澤 大介 米本 直裕 加藤 隆弘 橋本 直樹 岩戸 清香 青山 久美 佐藤 玲子 鈴木 志麻子 黒澤 美枝 神先 真
出版者
岩手医科大学
雑誌
基盤研究(C)
巻号頁・発行日
2010

医療、精神保健、および家族、社会的支援制度に該当する領域(法律、生活相談)、教育など幅広い領域におけるゲートキーパー養成プログラムを内閣府と協力して作成した。また、内閣府との共同で全国へ研修会やITを通じた普及を図り、ファシリテーター養成のためのプログラムを提供した。うつ病、統合失調症、不安障害、物質依存という4つの精神疾患の危機対応法プログラムとファシリテーター養成プログラムの開発を地域の精神保健に関する関係機関と共同で行い、有効性や妥当性を検証した。