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[眼部心身疾病——综述]

[Psychosomatic diseases of the eye--a review].

作者信息

Niklewski G

出版信息

Z Psychosom Med Psychoanal. 1982;28(3):300-16.

PMID:7124141
Abstract

After remarks on the uncritical use of the term "hysteria" in some investigations on psychosomatic phenomena in ophthalmology some recent reviews are presented, followed by the results of psychosomatic research on specific ophthalmological diseases. Dealing with glaucoma controlled studies are emphasized which attempt to determine the structure of neuroses and the importance of environmental situations. Using the MMPI high values on the scales 'depression', 'hypochondria' and 'hysteria' were observed. In previous attempts to influence glaucoma psychotherapeutically mainly autosuggestive and hypnotizing methods have been applied. The number of reported cases of psychogenic blindness has decreased considerably. We discuss, that it may not only be caused by the mechanism of hysterical conversion but also by a tendency to regression in schizoid neurotic structure. Concerning asthenopia and amblyopia the dependence of vision and visual acuity of the level of vegetative innervation is being accentuated; there appear to be correlations between certain errors of refraction and certain personality patterns. Psychiatric diseases may also influence vision: observations in paranoid and affective psychoses of later life and in schizophrenic children confirm it. This leads to the question, if schizoid neurotic structure can also be characterized by a specific disturbance in affective relations to sensations. Examples are given for investigations on other diseases (ablantio retinae, retinopathia centrales serosa), on the problem of self mutilation (auto-enuclation) and on neurophysiological question (psychogenic influences on pupil size).

摘要

在对眼科心身现象的一些研究中,对不加批判地使用“癔症”一词进行评论之后,本文呈现了一些近期的综述,接着是对特定眼科疾病的心身研究结果。在论述青光眼时,强调了旨在确定神经症结构和环境状况重要性的对照研究。使用明尼苏达多相人格调查表(MMPI)时,观察到在“抑郁”“疑病”和“癔症”量表上有较高分值。在以往试图通过心理治疗影响青光眼的尝试中,主要应用了自我暗示和催眠方法。报告的癔症性失明病例数量已大幅减少。我们讨论了,它可能不仅是由癔症性转换机制引起的,还可能是由类精神分裂性神经症结构中的退行倾向引起的。关于视力疲劳和弱视,视力和视敏度对植物性神经支配水平的依赖性正在得到强调;某些屈光不正与某些人格模式之间似乎存在关联。精神疾病也可能影响视力:对晚年偏执性和情感性精神病以及精神分裂症儿童的观察证实了这一点。这就引出了一个问题,即类精神分裂性神经症结构是否也可以由与感觉的情感关系中的特定障碍来表征。文中给出了对其他疾病(视网膜脱离、中心性浆液性视网膜病变)的研究、自残问题(自我眼球摘除)以及神经生理学问题(心理因素对瞳孔大小的影响)的调查示例。

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