著者

高橋 邦明 内藤 明彦 森田 昌宏 須賀 良一 小熊 隆夫 小泉 毅

雑誌

精神神經學雜誌 = Psychiatria et neurologia Japonica (ISSN:00332658)

巻号頁・発行日

vol.100, no.7, pp.469-485, 1998-07-25

被引用文献数

21

著者

須賀 良一

出版者

一般社団法人 日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.27, no.7, pp.611-616, 1987-12-01 (Released:2017-08-01)

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In our clinical practice, we often see depressive patients with a past history of physical illness. But it is unknown whether or not there is a significant relationship between depression and physical illness. Problems on the relationship of these two factors are summed up as follows : 1) Is there a significant relationship between depression and physical illnesss? 2) If there is, why is it? I took notice of the temporal cluster between the onsets of depression and physical illness to solve these problems. Purpose of this report is to give an answer to our questions. The samples were 61 patients (56.4±11.9 years old) who were diagnosed as major depression by Research Diagnostic Criteria. I interviewed them and made a survey of the past history of physical illness, the period between the onsets of depression and physical illness, psychosocial stressors (psychological situations of "over load" or "loss") prior to the present depressive illness and premorbid character (Typus melancholicus, etc). I made a statistical analysis by the method of Yokoyama of whether or not a temporal cluster between the onsets of depression and physical illness was significant. Then I investigated a relation of psychological stressor and premorbid character to the onset of psysical illness. The results were summarized as follows : (1) There was a significant temporal cluster between the onsets of depression and physical illnesses, which were gastro-duodenal ulcer, gastritis, asthma, irritable bowel syndrome and cerebral apoplexy. (2) Most of these four diseases except cerebral apoplexy occurred under the psychological situation of "over load", and they are categorized into psychosomatic disorders. (3) Cerebral apoplexy was a possible psychological risk factor for depression. (4) Most of the patients had a premorbid character of "Typus melancholicus." From the results described above, two reasons can be considered for the significant temporal cluster between the onsets of depression and physical illness. One reason is that some of physical illnesses, e.g. cerebral apoplexy, are a possible psychological risk factor for depression. The other is that psychological stressor and premorbid character of "Typus melancholicus" facilitate the onsets of both some physical illnesses and depression.