A Clinical Study of the Mental Disorders in Senility

老年期精神障害の臨床的研究を行い次の結果を得た. 1) 60才以上の入院患者244名中,進行麻痺,アルコール中毒症等と診断されたものを除く135名を主要症候より分類した結果,痴呆群23名(17%)躁うつ群25名(19%)妄想群23名(17%)神経症群14名(10%)錯乱譫妄群14名(10%)脳動脈硬化症群36名(27%)がみられた. 2) 発病年令より分類してみると, 188名中60才以前に発病したものは53名(28%)で60才以後に発病したものは135名(72%)で,病型別にみると躁うつ群,妄想群は約半数が60才以前に発病し,痴呆群,錯乱譫妄群は大部分が60才以後に発病していた. 3) 痴呆程度は躁うつ群,妄想群,神経症群では軽度にしか認められなかつた. 4) 遺伝負因は不明者が多く確実なことは分らなかつたが,躁うつ群,妄想群に痴呆群よりよく認められる様である. 5) 発病に対する直接的誘因は錯乱譫妄群で全例,躁うつ群,神経症群では約半数に認められたが,妄想群,痴呆群,脳動脈硬化症群では僅かしか認められなかつた. 6) 入院1年後の転帰は痴呆群では死亡,未治が全てで,軽快したものは1名もなく,躁うつ群,神経症群では軽快が多く未治がそれに次ぎ,妄想群では未治が一番多く次に軽快が多く,経過が長びく傾向にあり,錯乱譫妄群では死亡に次いで寛解が多く未治は全然なく患者は死亡もしくは寛解し,脳動脈硬化症群では軽決, 未治,死亡が大体同じ割合に認められた. 7) 錯乱譫妄群14名中8名は症候性精神病で,6名は心因により精神異常を示したもので症例を挙げ検討した. 8) 以上の各群について文献を挙げて考察を行い,症候性精神病を中心として鑑別診断についても述べた.The mental disorders of 188 inpatients over the age of 60 are summarized and classified herein. 1) 135 patients over the age of 60 excluding general paresis and alcoholism were studied and classified into six groups in the light of major symptoms. The demented group comprised 23 patients (17%), the manic-depressive, 25 (19%), the paranoid, 23 (17%), the neurotic, 14 (10%), the confused, 14 (10%) and the cerebral arteriosclerotic, 39 (27%). 2) 135 patients (72%) out of 188 had the onset of illness after the age of 60. So did the rest before 60. Approximately one half of the manic-depressive and the paranoid groups had fallen ill before the age of 60, while most of the demented and the confused groups had been taken ill after the age of 60. 3) Dementia was not so marked in the manic-depressive, the paranoid and the neurotic groups. 4) Heredity was suspected to be one of the major predisposing factors more in the manic-depressive and the paranoid groups than in the demented group. 5) Some precipitating factors of their mental disorders were found in all the cases of the confused group, found in one half of the manic-depressive and the neurotic groups, while only few cases had some precipitating factors in the paranoid, the demented and the arteriosclerotic groups. 6) A follow-up study for a year revealed that in the demented group all the cases died or not improved, in the manic-depressive and the neurotic groups, the improved cases were more abundant. In the paranoid group the unimproved rated most in the number and the improved followed them. The duration of the illness in the paranoid tended to be prolonged. In the confused group the dead were the most, lesser proportion remained in remission and none of them stayed stationary in the course of the illness. In the cerebral arteriosclerotic group the improved, the unimproved, the dead shared the same ratio. 7) The subgroups of mental disorders in the old age were surveyed, reviewing corres-ponding literatures