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題名 | 戀物症:一例報告=Fetishism: A Case Report |
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作者 | 陳志根; 張曉慧; 賴武賢; 蕭正誠; 葉頌壽; Chen, Chih-ken; Chang, Hsiao-hui; Lai, Wu-hsieu; Hsiao, Cheng-cheng; Yeh, Song-so; |
期刊 | 臺灣精神醫學 |
出版日期 | 19980600 |
卷期 | 12:2 1998.06[民87.06] |
頁次 | 頁73-79 |
分類號 | 415.875 |
語文 | chi |
關鍵詞 | 戀物症; 迷戀物; 心理治療; Fetishism; Fetish object; Psychotherapy; Fluoxetine; |
中文摘要 | 目的︰臺灣過去少有針對戀物症所作較大規模之臨床研究或深入完整的個案報告,本文利用一例個案討論此疾病之病因、臨床表現及治療上常面臨的限制。 病例報告︰一位27歲未婚男性主訴看見套腳式的橡膠拖鞋即有想手淫之衝動,並有偷竊拖鞋之行為。而回溯其成長過程,拖鞋一直扮演重要的客體角色,可能相關的早期經驗包括兒童時期性遊戲遭制止及遭異性拒絕經驗。此個案同時有輕鬱症,施予fluoxetine 20-40 mg/day及心理治療;其情緒改善且戀物及偷竊之行為頻率減少。 結論︰戀物症通常發病於青少年期,但其部份對該物體愛戀行為可以於兒童早期即呈現出來。患者可能承受巨大的社會及家庭壓力,心理治療宜採更多的接受與支持,支持性心理治療可以協助其應付壓力及混亂;雖然嫌惡療法曾被報告為有效的治療方法,但因此類患者常缺乏病識感及改變性行為之動機,宜在建立穩定治療關係後漸進地採用,並留意阻抗現象。 |
英文摘要 | Objective: There have been no large scale clinical studies on fetishism in Taiwan and there are few case reports. This article discusses the etiology, clinical manifestations and treatment limitations in patients with fetishism based on the report of a case. Case Report: A 27 years old single male complained of feeling the urge to masturbate when seeing slip-on rubber slippers and frequently engaged in thievery of these slippers. An examination of the patient's history revealed that the slippers had held a particular psychological importance for the patient since early childhood. The possible antecedent factors appeared to be complex and may have included being forbidden from childhood sex play and being rejected by the opposite sex. The client was also noted to have dysthymic disorder. After treatment with fluoxetine 20-40 mg/day and psychotherapy, his mood improved and the frequency of behavior associated with the fetish such as stealing decreased. Conclusion: Although the onset of fetishism is usually noted during adolescence, the fetishist may experience an attraction for the object in early childhood. These patients usually suffer from immense pressure from society and their families due to the bizarre nature of their behavior. Supportive psychotherapy can help the patient cope to alter behavior associated with the disorder as well as lessen the stress and chaos which it generates. Although aversive therapy has been reported to be the most effective treatment modality for fetishism, it should be applied gradually after a good rapport with the psychiatrist has been established. The lack of insight and motivation to change commonly found in these patients remains the major obstacle in successful treatment. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。