현대 정신의학에서 바라본 반 고흐의 정신세계와 정신질환에 대한 고찰

Abstract

Vincent van Gogh committed suicide at age 37 in July 1890. Although 130 years have passed since his death, his tragic mental illness and dramatic life experience, together with his extraordinary artistic achievements, have fascinated many people, and many physicians have proposed diagnostic hypotheses and related evidence continuously. The diagnoses of physical illnesses included temporal lobe epilepsy, Meniere’s disease, acute intermittent porphyria, tertiary syphilis, absinthe abuse, terpenoid/lead poisoning, glaucoma, cataract, and digitalis intoxication. Possible psychiatric diagnoses include borderline personality disorder, mood disorder with depressivemanic episodes, and schizophrenia. This article reviews the current information on Vincent’s life, letters, medical records, insight into his disease, testimonies of acquaintances, and other evidence and viewpoints on his illness. In summary, Vincent’s premorbid personality showed signs of borderline personality disorder with continuous conflicts with close people. He had long depressive episodes followed by hypomania multiple times throughout his life. Temporal lobe epilepsy has been raised as the principal diagnosis to explain his periodic memory loss, auditory/visual hallucinations, persecutory/religious delusions, and self-injurious behavior. On the other hand, bipolar disorder and schizoaffective disorder are also recognized as core diagnoses due to the expanding concept of mania and hypomania in the late 20th century. The aggravating factors to his symptoms could have been events provoking separation anxiety from Theo and neurotoxic substance abuse, including absinthe. Vincent’s psychiatric symptoms are difficult to explain with a single diagnosis, but the author suggests schizoaffective disorder, bipolar type, showing the characteristics of bipolar disorder and schizophrenia.