＜シンポジウム（3）―16―3＞神経学と精神医学の境界を再度越える
精神医学的症状を神経心理学から捉える
加藤 元一郎
慶應義塾大学医学部精神神経科〔〒160―8582 東京都新宿区信濃町35〕
Neuropsychological symptom-oriented approach is a critical method to elucidate delusion and psychotic symptoms in patients with focal brain damages and schizophrenia. In Capgras delusion (CD), the delusional misidentification of familiar people disguised as others, the patients with right amygdala damage and bilateral ventromedial prefrontal lesions have a deficient or reduced emotional valence of the person with intact configurational processes of the face. Reduplicative paramnesia (RP) is a specific phenomenon characterized by subjective certainty that a familiar place or person has been duplicated. Clinical evidences indicated that the patient with RP following right prefrontal damages showed the lack of emotional valence for the present hospital. This abnormal sense of familiarity triggered the deficits of the orientation of self to the outside world, that is, double orientation, resulting in the development of geographical reduplicative paramnesia. In line with the pathogenesis of CD and RP after brain damages, the delusion in schizophrenia may have a germ as developmental origins, which include the aberrant or salient perceptual experiences and abnormal sense of agency, and might be further aggravated by the impairment of causal reasoning process such as the jumping-to-conclusions bias.
Full Text of this Article in Japanese PDF (196K)
(臨床神経, 52：1379−1381, 2012)
key words：神経心理学，妄想，カプグラ症候群，重複記憶錯誤，情動
（受付日：2012年5月25日）
