[A clinical study on the therapeutic significance of classifying total amnesia].
Eight cases of total amnesia were reported. In common to all the cases, there were the definite histories of characteristic situations charged with depressive and isolated mood, although their modes of social adjustment appeared relatively good respectively. Four of the eight cases presented the clinical course of total amnesia as Yamada et al. had previously pointed out. The other four developed total amnesia in peculiar progress and presented rather involved clinical courses. Examining the clinical courses and psychodynamics, the author has suggested that total amnesia would be able to classify two types, such as "simple course type" and "unstable course type". The important difference between two types is as follows. "Simple course type": There were pressing situations after series of actual pending problems such as debts, troubles with a lover and mismanagement in business. Onset of them were reactive under these environmental situations. They presented calm and stable features during partial amnestic period. As the family relations and the actual environments were improved better, they recalled more parts of their personal histories without any difficulty. "Unstable course type": In these cases, the intrapsychic weakness were more important factors than the actual environmental problems. Unlike "simple course type", whenever they recalled some parts of their personal histories, they presented unstable fluctuating features with confusion. Therefore, they needed intensive therapeutic intervention and concern. Generally speaking, total amnesia can be considered not only as defense for the actual conflicts with a repression mechanism but also as "psychologic suicide" which Abeles et al. have mentioned. In addition, emotionally confused evolution in this type may be regarded as exposure of the intrapsychic weakness itself. By the way, the close relationship between total amnesia and suicide has been mentioned in some papers. In this type of total amnesia, attempted suicides were actually seen. So the author has stressed that the risk of suicide should be impressed in the treatment of total amnesia. Among the previously reported cases of total amnesia, in which the clinical courses can be read, 27 cases are "simple course type" and 22 cases are "unstable course type" according to the author's knowledge. And the number of total amnesia has been increasing with the times. So in future, total amnesia may increase in number. The author has emphasized the therapeutic significance of classifying total amnesia. It is useful for the treatment of total amnesia to recognize "unstable course type", in order to foresee the unstable clinical course.(ABSTRACT TRUNCATED AT 400 WORDS)
Ohya
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Department of Neuropsychiatry, Kansai Medical University.
D000328:Adult; D000647:Amnesia / Q000145:classification / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D013315:Stress, Psychological; D013406:Suicide, Attempted