Studies of Blood Pressure in Psychiatric Patients Under Stress

Abstract

The main purpose of the present study was to determine whether, under stress, the blood pressure in psychoneurosis would deviate significantly from normal. Subjects were 37 psychoneurotics, 20 normal controls, 10 acute psychotics, and 16 chronic schizophrenics, whose blood pressure reactions were recorded continuously by means of an automatic recorder. Three standard situations of stress were employed. These involved (1) pain stimulation, (2) a rapid discrimination task, and (3) mirror drawing. Under stress, the rise in systolic blood pressure was greater in the psychoneurotic group than in controls. The most consistent difference between psychoneurotics and normals was in the psychoneurotics'' continuation, or progressive increase of high blood pressure, during a later phase of a stress situation, when the normals'' reaction was showing definite signs of being held in check. This finding suggests that in psychoneurosis, there may be a basic deficiency in some regulatory mechanism which normally operates to check excessive rise in blood pressure. Two lines of evidence supported the proposition that degree of autonomic reaction may be inversely related to amount of direct skeletal motor expression. Evidence was obtained that individual constancy of blood pressure reaction may be high, and particularly high under stress. Chronic schizophrenics resembled normal controls in systolic blood pressure reaction to stress, a finding which is inconsistent with the view that these patients are abnormally sluggish under stress. The chronic schizophrenics differed from controls and other patients in that they showed higher diastolic and lower pulse pressure.