[Cenesthopathy in the presenium associated with manic factor resolved with lithium carbonate: two female cases with underlying manic or mixed state].

Cenesthopathy is a syndrome where patients persistently complain of abnormal sensations in some particular parts of their body, giving them odd descriptions, with the sensations being medically unexplainable. It is also often chronic and refractory to treatment It is commonly divided into two types: one is defined in a narrow sense, with only an abnormal sensation of the body as the main symptom, and the other in a wider sense, where the sensation is a syndrome accompanying schizophrenia, depression, or organic psychiatric disorder. The nosological evaluation of cenesthopathy has not been established. We report two pre-senile female patients with cenesthopathy under agitated conditions continuing for years, with a diagnosis of depression, and they were resolved with lithium carbonate administered for a manic or mixed state exhibited later. There have been few reports on cenesthopathy accompanying a manic or mixed state, or the effect of lithium carbonate on such a condition. Our cases showed that a manic factor or mixed state plays an important role in agitated symptoms often observed in pre-senile and senile depression. We propose that the hypochondriacal state involving cenesthopathy may be strongly associated with a manic factor, as has been psychopathologically discussed in foreign and domestic literature, including studies of Ey, H. and Leonhard, K. Although cenesthopathy has been mainly treated with antidepressants and antipsychotics, considering the weight of a manic factor and mixed state, mood stabilizers such as lithium carbonate at an adequate dosage may prove to be effective.