Personality and Psychosomatic Disturbances in Patients on Medical and Surgical Wards: A Survey of 450 Admissions*

Abstract

By means of psychiatric interview a survey was made of 450 admissions to medical and surgical wards. Twenty per cent were classified as having mild and ten per cent as having severe, neuroses. These disturbances were grouped as follows: A. Pre-existing personality problems aggravated by infection or trauma (30%). B. Personality disturbances precipitated by or first becoming evident in association with infection or trauma (37%). C. Personality disturbances with serious defects in structure or function (20%). D. Personality disturbances in patients without gross structural defect but with excessive complaints and disturbances of function (8%). E. Trauma resulting from personality disturbances (4%). The patient's difficulties arose in connection with the threat to bodily safety, frustration of dependency needs, hostility, sexual problems and the failure to live up to high standards of achievement. All patients had conflict between group ideals and desire for protection. In some instances the individual was aware of it, in others he was not. In psychopathic individuals feelings of frustration and guilt expressed themselves in diffuse hostility and in defiance of accepted social ideals.