ON SOME ASPECTS OF HYSTERIA

Abstract

A review of recent psychiatric consultative reports submitted to the Social Security Administration does not support the belief that conversion reactions are disappearing. The rationale for the diagnosis and prognosis of this disorder was felt to be inadequate in many cases studied. The records of 100 in-patients diagnosed as hysteria, after study and treatment, at the Henry Phipps Psychiatric Clinic between the periods 1913-1920, and 1945-1960, were studied. The admission rate was not appreciably different in the 2 periods, nor were the reported symptoms significantly different. Only 9% of the patients were felt to be "hysterical personalities" as defined by Chodoff and Lyons, and indifference to symptoms was noted in only 32% of the patients. The personalities studied were most generally characterized as markedly immature or dependent. It may be of psychodynamic significance that 30% of the patients were either the youngest or the only child in the family and that 54% of the patients appeared to have experienced childhood affec-tional deprivation. Reference to the classical libido theory is not considered necessary for the diagnosis, treatment, or psychodynamic understanding of cases of hysteria. The need for further research integrating recent developments in ego psychology and concepts of hysteria is suggested.