はじめに
こんにちは。精神科医として心の健康に関する情報を発信している、精神科医ブロガーのやっくん(@mirai_mental)です。
今回は、「体感幻覚」という精神科の用語について解説していきます。
体感幻覚とは
体感幻覚(たいかんげんかく)は、幻覚の一種で、「実際にはあり得ないはずの体の感覚を感じてしまう」症状です。
幻視や幻聴は、実際にないはずのものが見えたり声が聞こえたりする症状ですが、体感幻覚はそうした異常が身体の感覚について起こってしまう現象です。
その内容は、グロテスクな内容のことも多いです。例えば、「皮膚の下で血管がグネグネとうごめいている」「脳が溶けているような感じがする」「体の中に鉄板が入っている」といった、異常な感覚を訴えることが多いです。
似たような言葉の一つに、「セネストパチー」というものがあります。
この言葉は、体感幻覚の症状を表すこともあれば、体感幻覚が主な症状として見られる病気の状態像を指す言葉として使われることもあります。
参考:【精神科医が解説】セネストパチーってなに?どんな症状が見られる?
どのような病気で見られる?
統合失調症は幻覚や妄想などが起こる病気ですが、幻聴などの主要な病的体験に加えて、グロテスクな体感幻覚が見られることがあります。
またうつ病でも体感幻覚が見られることがあります。重症のうつ病におけるコタール症候群という言葉がありますが、これは微小妄想の究極系のような形で「内臓が溶けてなくなってしまう」「体が消滅してしまう」などの奇妙な感覚を訴えることが特徴です。
認知症に関して言えば、レビー小体型認知症というタイプの認知症では、妄想や幻覚が見られることが多いです。頻繁にではありませんが、レビー小体型認知症などでも体感幻覚を認めることがあります。
症状が元々の病気の一環として生じていると考えられる場合は、原病の治療を行うことで症状がよくなることがあります。
一方、他の症状はあまり目立たず、体感幻覚のみが主な症状として見られる状態像を目にすることもあります。(いわゆる広義のセネストパチー)また比較的高齢の女性で、口腔内の異常感覚を訴える方も見かけます。(口腔内セネストパチーと呼ばれます)
こうした場合は、抗精神病薬など幻覚に対する薬物療法を行うこともありますが、いまいち反応がはっきりしないこともあり、難航することもあります。
終わりに
体感幻覚は、統合失調症などで見られる身体的異常感覚のことを言います。
内臓の感覚など、体に非常に奇妙でグロテスクな訴えが見られることもあり、特徴的な症状として頭に入れておくといいでしょう。
似たような症状として、セネストパチーやコタール症候群について以下で解説しています。
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