A STUDY OF THE MODIFICATION OF MENTAL ILLNESS BY INTERCURRENT PHYSICAL DISORDERS IN ONE HUNDRED PATIENTS

This study demonstrates statistically in an unselected group of 100 male patients the frequent favorable influence of intercurrent physical disorders upon the course of mental illness. Not infrequently, as seen in II percent of the patients, the physical illness appears to precipitate recovery. The analysis of the 100 cases has revealed that the age of the patient is of little or no significance. The duration of the mental illness prior to the appearance of the physical disorder, however, does appear to have significance; of those hospitalized less than one year, 75 percent revealed improvement, while in those hospitalized for mental illness over one year, only 40 percent showed improvement following intercurrent physical disorder. Personality factors, whether of aggressive or passive type as judged by outward behavior appeared from this study to have little or no influence on the reaction to physical disorder. In contrasting the two most frequently observed trends it was observed that improvement was more consistently associated with a depressive trend than with a persecutory trend. Accidental or self-inflicted injuries proved to be a stimulus for improvement in a high proportion of patients. There were 9 self-inflicted and 13 accidental injuries making a total of 22 patients injured, with improvement occurring in 18 instances or in over 85 percent of these patients. The patients with self-inflicted injuries did somewhat better as a group than those with accidental injuries. Generally speaking, these patients who showed mental improvement in relation to physical disorder also did so with shock treatment although a substantial number improved with shock treatment who did not do so with intercurrent physical illness. In those who showed a capacity for improvement in response to both shock therapy and physical disorder, the prospect of sustained improvement or recovery was better than in those who were improved in relation to physical illness alone or shock therapy alone. A total of 67 of the 100 cases showed improvement following intercurrent physical disorder, with the improvement proceeding directly to recovery in 11 patients. The most striking and consistent change appeared in the 34 manic-depressive cases, with improvement in 26 instances. The manic-depressive depressed group, however, did the best with 14 out of 15 showing improvement. The patients who already had organic brain disease, as might be expected, did least well in relation to intercurrent p