著者

郷久 鉞二

出版者

札幌医科大学

雑誌

札幌医学雑誌 = The Sapporo Medical Journal (ISSN:0036472X)

巻号頁・発行日

vol.43, no.1, pp.5-20, 1974-04-30

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Psychological considerations for the treatment in the field of ohstetrics and gynecology arc reported in this study as a result of a psychosomatic approach. 1) Psvcological tests were carried out in 213 cases of sterile women, using the Cornell Medical Index (CMI) and the Yatabe-Gilford test (YG). 148 cases showed normal patterns. 65 cases showed neurotic patterns. 57 cases, 38.4% in the former and 43 cases, 66.1% in the latter required hormone therapy alone or combined with other therapeuitic means. 5mg of Diazepam were administrated intravenously in the course of the Rubin's test, and the resultant patterns were studied. The group which showed a normal pattern in the psychological tests showed a 34.4% effectivity to Diazepam and others showed no change or somewhat spastic patterns. On the other hand, the group that showed neurotic patterns in the psychological tests showed a 4.2 effectivity to Diazepam while others showed no response or somewhat spastic patterns. 2) 33 cases suffering from symptoms of climacterium were treated with hormone therapy alone. All 10 cases showing a normal pattern of CMI showed good results, and 43% out of 23 cases showing neurotic patterns showed good results. 82% out of 22 cases showing a normal pattern in YG showed good results and 33% out of 6 cases showing an abnormal pattern gave good results. 8 cases showing no effect in response to hormone therapy were treated dy psychosomatic therapy. 3) The cases of frigidity and colpospasm were classified by their resistence to the treatments. 4)Two cases of the pseudocyesis were studied. 5) The group of pregnant women who gained 30 points or ovea of the N and E scorings in the Maudsley test (MPI) suffered from hyperemesis graviclarum (P<0.05.) 6) The scoring of Tayler's Anxiety test (MAS) and MPI for pregnant women showed different patterns according to the period of the pregnancy and especially in the case of 29-36 weeks of nulipara they showed a high scoring. It seems that the high scorings of MAS had a relationship to a subinvolution of uterus namely, a hypogalactia, resulting in birth of smoll for date babies (P<0.10). 7) The neurotic group had an unreasonable tense attitude psychologically speaking. These cases showed a small subjective effect in painless delivery in which fluothane gas was administered and complaints of the first stage of the laber were noted. 8) In testing pregnant women in whom labor lasted for 10 hours and running a comparison against the results in pregnant women in whom labor lasted more than 10 hours, it was found by MPI that those who had a higher tendency toward extroversion and neurotic patterns had longer labor (P<0.01).