题名

Lorazepam Interview for Psychogenic Aphonia

并列篇名

靜脈注射Lorazepam會談於心因性失聲之臨床運用

DOI

10.29478/TJP.201203.0008

作者

蕭暉獻(Hui-Hsien Hsiao);歐陽文貞(Wen-Chen Ouyang)

关键词

心因性失聲 ; benzodiazepine治療 ; 身體型式疾患 ; psychogenic aphonia ; benzodiazepine interview ; somatoform disorder

期刊名称

台灣精神醫學

卷期/出版年月

26卷1期(2012 / 03 / 01)

页次

6+64 - 68

内容语文

英文

中文摘要

目的:過往對於轉化症執行藥物會談之成效並無太多證據,而執行lorazepam會談於心因性失聲個案之相關報告則更加缺乏。個案報告:一名40歲被先生懷疑不忠貞的失聲已婚婦女病人,住院期間安排身體檢查及腦部MRI以排除其他器質性原因,之後診斷為心因性失聲,在穩固醫病關係後,執行lorazapam藥物會談,於會談過程中並搭配觀看圖卡的方式來幫助發聲,當時可發單音循序漸進至片語,隔日她就能說話。結論:轉化症之心因性失聲病人,使用靜脈注射lorazapam來執行藥物會談搭配圖卡,為臨床上一可參考之治療方式。

英文摘要

Background: Conversion disorder is thought of using physical symptoms to symbolize unbearable psychological symptoms. The value of drug interview in treating conversion disorder is at present unknown and few studies exist in reporting lorazepam interview for psychogenic aphonia. Case report: A 40-year-old female patient suffered from aphonia suddenly after her husband mistrusted her infidelity. She received surgical treatment of pituitary gland tumor one month before her onset of aphonia. After visiting psychiatric outpatient clinic, she was carefully examined. She did not show any apparent MRI findings related to aphonia. She was diagnosed as psychogenic aphonia, and she started to phonate 1-2 syllables during lorazepam interview with cards of pictures and word messages, and she could speak several words 5-6 hours later. On the following day she could speak fluently. Conclusion: We suggest that lorazepam interview with proper use of cards with pictures and word messages could be one of treatments for patients with psychogenic aphonia.

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. Semenov H: Deafness of psychic origin and its response to narcosynthesis. Trans Am Acad Ophthalmol Otolaryngol 1947; 51: 326-48
  2. Hafeiz, HB(1980).Hysterical conversion: a prognostic study.Br J Psychiatry,136,548-51.
  3. Kim, JS,Cho, EJ,Park, LJ,O, JS(2010).Conversion phenomenon during the induction period of general anesthesia: case report.Korean Journal of Anesthesiology,59,210-3.
  4. Kirsch, I(1999).Hypnosis and placebos: response expectancy as a mediator of suggestion effects.Anales de Psicologia,15,99-110.
  5. Kroenke, K(2007).Efficacy of treatment for somatoform disorders: a review of randomized controlled trials.Psychosom Med,69,881-8.
  6. Poole, NA,Wuerz, A,Agrawal, N(2010).Abreaction for conversion disorder: systematic review with meta-analysis.Br J Psychiatry,197,91-5.
  7. Sadock, BJ(ed.),Sadock, VA(ed.)(2000).Kaplan & Sadock's Comprehensive Textbook of Psychiatry.Baltimore:Lippincott Williams & Wilkins.
  8. Sadock, BJ(ed.),Sadock, VA(ed.),Kaplan, HI(ed.)(2005).Comprehensive Textbook of Psychiatry.Philadelphia:Lippincott Williams & Wilkins.
  9. Schecker, N(1990).Childhood conversion reactions in the emergency department: part II-general and specific features.Pediatr Emerg Care,6,46-51.
  10. Shen, WW(2011)。Clinical Psychopharmacology for the 21st Century。Taipei:Hochi Publishing Company。
  11. Stevens, CB(1990).Lorazepam in the treatment of acute conversion disorder.Hosp Commu Psychiatry,41,1255-7.
  12. Sumathipala, A(2007).What is the evidence for the efficacy of treatments for somatoform disorders? critical review of previous intervention studies.Psychosom Med,69,889-900.