腎移植の心身医学的研究 : 失感情症を呈した腎不全患者の1例を通じて

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  • Psychosomatic Problems of Renal Transplantation : Through a renal failure patient with alexithymia
  • ジン イショク ノ シンシン イガクテキ ケンキュウ シツカンジョウショウ オ

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Psychosomatic problems surrounding renal transplantation were discussed through observing the psychological process of a case with alexithymia during hemodialysis (HD) therapy prior to transplantation. The patient was a male of 42 years of age. During the early stage of HD initiation, he was comparatively positive in adapting to the new environment including HD therapy. As the HD therapy continued, the patient eventually became alexithymic. We assumed that the manifestation of alexithymia was related to his denial of a serious traumatic experience during his early childhood. Furthermore, it was indicated from the psychoanalytical standpoint that his deficient self-management associated with alexithymia was derived from the strong defense mechanism. In treatment, we made efforts to understand empathetically his view of the problems and to establish a common treatment goat between patient and therapist. We then made detailed plans to solve his problems and carried them out in the way which was acceptable to him. Moreover, stimulations were given to bring to the surface his anxiety and hypochondriasis which were repressed by the defense mechanism. This approach was effective enough to improve alexithymia and lack of self-regulation. It became possible for the patient to perform smooth post-transplant physical management. This treatment result indicated that alexithymia is reversible, suggesting the necessity to consider the indication of renal transplantation based on psychosomatic findings including alexithymic manifestation. For this reason, we consider this case report quite valuable for reference in future consultation-liaison psychiatry.

収録刊行物

  • 心身医学

    心身医学 32 (4), 339-346, 1992

    一般社団法人 日本心身医学会

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