老年期せん妄状態の臨床的研究

明らかな脳器質的障害によって精神症状を示すものを除いた老年期せん妄状態について,臨床的に観察調査した.発生頻度は老年期精神疾患の9.5%であり,そのうちの35例について次の如き結果を得た.性格傾向は,内気,小心,神経質など内向的性格が21例中17例を占め,発症年月は,冬季においては35例中2例と極めて少なく,夏季には17例で全体の48.7%に達している.せん妄期間は平均29日で,転帰は,寛解24例,死亡7例,軽度の痴呆とか感情失禁など一部の症状を残して治癒したもの4例であった.誘因により4群に分類すると,Ⅰ.身体因によるせん妄群,Ⅱ.心因によるせん妄群,Ⅲ.心因,身体因によるせん妄群,Ⅳ.誘因の認められないせん妄群,となり,ⅡおよびⅢ群は女性が,14例中13例と多くを占め,心因と女性のせん妄とめ関連がうかがわれた. Weinsteinらの方法によるアミタール・テストにより,意識ないし見当識保持に関する予備能を検し,老年期せん妄の発症には,1)性格的素因,2)身体因,3)心因(特に女性),4)予備能の減弱が重要な因子となることを述べて考察した.治療にシチジンモノ燐酸を用い,13例中7例と,50%以上の有効率を認めた.

Clinical observations were conducted on cases of confusional state in senility excluding those showing clear-cut symptoms of encephalic origin. As a result about 10 per cent of psychic patiens in senility proved to be in confusional state, and of them 35 cases were selected for further study and they were classified into four groups according to the following factors: namely, group Ι due to physiological factor; group Ⅱ due to cardiac factor; group Ⅲ due to physiological and cardiac factor; and group Ⅳ revealieg not any definitive causative factors. In amital tests carried out by the method of Weinstein as probing tests for the reserve capacity of consciousness or perception, it has been demonstrated that in the confusional state of senility, personality, weakening of reserve capacity, cardiac factor (predominantly in females), and physiological factor constitute important causative factors. For the treatment of 13 such cases cytidine-monophosphate was given, and such a treatment proved effective on 7 cases (over 5) per cent of them).