Abstract
IntroductionPatients suffering from ear discomfort are commonly encountered in the department of otolaryngology. If various clinical examinations do not reveal any objective findings, then the patients are referred to the department of internal medicine or psychiatry. Psychotherapy is recommended in some cases. This paper describes the successful administration of autogenic training in a patient suffering from ear discomfort due to major depression.Case presentationWe present a case of intractable depression that was successfully treated with a combination of psychotherapy, administered by a clinical psychologist, and high-dose antidepressant. The patient was a 36-year-old female with hearing discomfort in her left ear. In 2003, she experienced insomnia and an appetite loss, and her condition was diagnosed as major depression along with an avoidant personality disorder. Her depression has not been improved with antidepressant treatment for 3 years in department of psychosomatic medicine. She was referred to our department because of ear discomfort in her left ear. There was no abnormality in her physical examinations. She wanted to be treated in department of otorhinolaryngology. We increased the dose of fluvoxamine maleate up to 200 mg/day, and introduced cognitive therapy and autogenic training by a clinical psychologist. Eventually, her depressive state as well as the hearing complaint was markedly alleviated.ConclusionAutogenic training can be a viable and acceptable treatment option for patients who fail to respond to other therapies. This case emphasizes the importance of autogenic training as a method to control physical symptom of depression.
Highlights
Patients suffering from ear discomfort are commonly encountered in the department of otolaryngology
This paper describes the successful administration of autogenic training in a patient suffering from ear discomfort due to major depression
Case presentation: We present a case of intractable depression that was successfully treated with a combination of psychotherapy, administered by a clinical psychologist, and high-dose antidepressant
Summary
She was diagnosed as major depression and medical treatment was introduce with fluvoxamine maleate 150 mg (t.i.d.), zolpidem tartrate 5 mg, ethyl loflazepate 0.5 mg and trazodone hydrochloride 25 mg (v.d.s.) She was referred to our department because of the hearing discomfort in the left ear. The results of the psychological examination were as follows: Self-rating Depression Scale (SDS), 52; Japanese version of the Cornell Medical Index (CMI), IV; Manifest Anxiety Scale (MAS), 31, and Y-G (Yatada-Guilford personality inventory); AE We diagnosed her as major depression by DSM-IV [1] because of her depressed mood most of the day, markedly diminished interest or pleasure in all, significant weight loss, and insomnia. Her depressive state, anxiety (Table 1) as well as the hearing complaint was markedly alleviated
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