憂鬱症、轉化、附身與家庭關係：一項社會文化研究

Depression, Conversion, Possession and Family Relations: A Sociocultural Study

目的：憂鬱症的社會文化模式在儒教取向社會的基本假設是，其精神病理學係受人際和 諧關係的困擾而定。本代表性病例研究之目的在探討精神健康與儒教文化的相關議題。病例報告： 本病例是一位罹患重度憂鬱症之46 歲家庭主婦病人。其臨床症狀的進展，從身體 化，戲劇型轉化，到解離型恍惚與靈魂附身現象，明顯展示病人家族下意識發展而成的防衛 與因應機轉，目的是恢復人際關係的平衡。結論：本病例具有一良好意涵，即伴隨儒教，道 教、佛教及薩滿教影響了東亞享有共同文化價值觀者的精神健康及精神疾病症狀

Objective: A socio-cultural model of depression in Confucianism-oriented societies has the basic assumption that its psychopathology is determined by the disturbance of a harmonious relationship with others. We present a case study in the context of the socio-cultural background to address the relevant issues regarding mental health. Case Report: A 46-year-old housewife patient with major depressive disorder, had progressive clinical features from somatization, hysterical conversion, to dissociative trance and spirit possession, through the emotional turmoil involving family relational problems. In the recovering process, the psychiatrists showed that she expressed the defense and coping mechanisms consciously to recover the interpersonal equilibrium. Conclusion: The authors suggest that in this case report, Confucianism, Taoism, Buddhism, and Shamanism have infl uenced mental health, and mental illnesses of the people who share the common socio- cultural values in East Asia.