Ueda Satoshi, Marutani Toshiyuki, Okubo Yoshiro
Department of Neuropsychiatry, Nippon Medical School.
Seishin Shinkeigaku Zasshi. 2013;115(2):127-38.
Cenesthopathy is a syndrome where patients persistently complain of abnormal sensations in some particular parts of their body, giving them odd descriptions, with the sensations being medically unexplainable. It is also often chronic and refractory to treatment It is commonly divided into two types: one is defined in a narrow sense, with only an abnormal sensation of the body as the main symptom, and the other in a wider sense, where the sensation is a syndrome accompanying schizophrenia, depression, or organic psychiatric disorder. The nosological evaluation of cenesthopathy has not been established. We report two pre-senile female patients with cenesthopathy under agitated conditions continuing for years, with a diagnosis of depression, and they were resolved with lithium carbonate administered for a manic or mixed state exhibited later. There have been few reports on cenesthopathy accompanying a manic or mixed state, or the effect of lithium carbonate on such a condition. Our cases showed that a manic factor or mixed state plays an important role in agitated symptoms often observed in pre-senile and senile depression. We propose that the hypochondriacal state involving cenesthopathy may be strongly associated with a manic factor, as has been psychopathologically discussed in foreign and domestic literature, including studies of Ey, H. and Leonhard, K. Although cenesthopathy has been mainly treated with antidepressants and antipsychotics, considering the weight of a manic factor and mixed state, mood stabilizers such as lithium carbonate at an adequate dosage may prove to be effective.
体感异常是一种综合征，患者持续抱怨身体某些特定部位有异常感觉，给出奇怪的描述，且这些感觉在医学上无法解释。它通常也是慢性的且治疗难治。它一般分为两种类型：一种是狭义定义，仅以身体异常感觉为主要症状，另一种是广义定义，该感觉是伴随精神分裂症、抑郁症或器质性精神障碍的一种综合征。体感异常的疾病分类评估尚未确立。我们报告了两名老年前期女性患者，她们在多年的激动状态下患有体感异常，诊断为抑郁症，后来给予碳酸锂治疗躁狂或混合状态后病情得到缓解。关于伴随躁狂或混合状态的体感异常以及碳酸锂对这种情况的影响的报道很少。我们的病例表明，躁狂因素或混合状态在老年前期和老年抑郁症中经常观察到的激动症状中起重要作用。我们提出，涉及体感异常的疑病状态可能与躁狂因素密切相关，正如国内外文献包括对埃伊（H. Ey）和莱昂哈德（K. Leonhard）的研究所进行的心理病理学讨论那样。尽管体感异常主要用抗抑郁药和抗精神病药治疗，但考虑到躁狂因素和混合状态的影响，适当剂量的碳酸锂等心境稳定剂可能被证明是有效的。
