いわゆる境界例についての臨床的研究

A clinical name of "Borderline Case" is generally used for such a case which is very difficult to diagnose as schizophrenia or neurosis. It is inevitable that the various cases with different genesis and symptomatology are classified in the borderline case, as the concept and the diagnostic standpoint of schizophrenia or neurosis are not uniform. Although there are many papers on the psychodynamic structure of the borderline case, the clinical pictures of this case are not the same. The author feels that the further clinical observation and the classification are also necessary as well as the psychodynamics of the borderline case. 17 cases are observed and classified into 3 types, who had been the in-patient during two years, from Jan. 1961 to Jan. 1963, at the Dep. of Neuro-Psychiatry, Okayama University Hospital. 1. Pseudoneurotic Type Various neurotic symptoms such as anxiety, phobia, obsession and neurasthenic symptom are flourish. Thought disorder or the superficial emotional contact are prominent in most cases, but autism, the primary schizophrenic disorder is not remarkable in some of these cases, although Hoch, P. insisted that pseudoneurotic schizophrenia is not the borderline case, but a sub-type of schizophrenia. 2. Type of Character Deviation Symptoms are vague and transient, and the disorders of the social life due to the various abnormal behavior and the distortion of the inter-personal relationship are characteristic. Severe disorder of the personality which is difficult to differentiate from psychopath or simple schizophrenia is cardinal in this type. 3. Mono-symptomatic Type Delusional interpretation about his shape, expression or smell persists for a long period. The appearance of the symptom is closely related with the special situation, the presence of other peoples, and the disorder of the personality is minimum. In these cases, the neurotic picture is more evident than in the other types.