靜脈注射Lorazepam會談於心因性失聲之臨床運用

Lorazepam Interview for Psychogenic Aphonia

目的：過往對於轉化症執行藥物會談之成效並無太多證據因性失聲個案之相關報告則更加缺乏個案報告：一名，而執行 lorazepam 會談於心婦女病人，住院期間安排身鱟檢查及腦部 MRI 40 歲被先生懷疑不忠貞的失聲已婚失聲，在穩固醫病關係後，執行 lorazapam 來幫助發聲，當時可發單音循序漸進至片語以排除其他器質性原因，之後診斷為心因性病人，使用紳脈注射 10rozapom 藥物會談，於會談過程中並搭配觀看圖卡的方式，隔日她就能說話。結論：轉化症之心因性失聲來執行藥物會談搭配圖卡，為臨床上一可參考之治療方式。

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 infi - delity. 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 fi ndings 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 fl uently. 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.