[Affect as a mirror of internalized object relations]. / Die Affekte als Spiegel internalisierter Objektbeziehungen.

Differently structured interview situations, simultaneously covering physiologic and psychologic parameters, were employed in the investigation of groups of patients suffering from either colitis or cardiac neuroses. Verbally expressed emotions in this context were evaluated by means of the Gottschalk-Gleser-Technique. It is implied that in each instance topical interaction patterns simultaneously incorporate internalized object relations linked up with the respective emotions. Hence the dynamics of previously internalized patterns of relations in the two groups of patients described can be reconstructed with the aid of psychoanalysis. Generally, patients suffering from colitis tend to express their anxieties and aggressions on a physical level whereas those suffering from cardiac neuroses are better capable of using language as an "outled valve" for their emotions.

[Psychosomatic differentiation between colitis ulcerosa and ileitis terminalis (Crohn disease)]. / Zur psychosomatischen Differenzierung zwischen Colitis ulcerosa und Ileitis terminalis (M. Crohn).

The discussion on the differentiation of colitis ulcerosa and ileitis terminalis (M. Crohn) respectively has not as yet been settled in regard to their psychosomatic aspects. This study attempts to examine differences in the psychic manifestation occasionally discussed in the literature and in the clinical environment with the aid of psychological tests and data won by means of semi-standardized interviews. The results support the hypothesis that there are differences in the psychic structures of the patients from the two samples. Patients suffering from colitis ulcerosa show a closer resemblance to one another than the M. Crohn patients. The general impression is that they area "more normal" and better adjusted. Among the M. Crohn patients a difference must be made between an older, depressive part of the sample, and a younger, more active group with pronounced dependency conflicts. The connections with psychodynamic interpretations are discussed.

[Psychosomatic differentiation in patients following myocardial infarct]. / Zur psychosomatischen Differenzierung von Patienten nach Herzinfarkt.

An experimental study, based upon clinical impressions and theoretical considerations toward a differentiation of patients having suffered cardiac infarction, was employed to investigate the question of differentiation with regard to specific psychosomatic therapy. In conformity with other investigations it was observed that the patients with cardiac infarction could be classified into three groups. The theoretical considerations combined with the results from the experiments were the basis for the recommendation of specific therapeutic measures for each of the three groups: athletic group therapy for the more impulsive patients, single and group therapy for patients with regressive tendencies, combined group therapy in autogenetic training for sociable patients.

[Investigations of the plasma cortisol in psychiatric diagnostic groups (author's transl)]. / Untersuchungen des Plasma-Cortisols bei psychiatrischen Krankheitsgruppen.

In 23 endogenous depressives, 24 schizophrenics, 15 manics, 23 depressed neurotics, 23 nondepressed neurotics and 29 nonpsychiatric patients as controls, the plasma cortisol in the morning (7:30 a.m.) and the evening (7:30 p.m.) was measured with radioimmunoassay. Comparing the means of the groups, significant differences were found. In the morning the means of the nondepressed neurotics (-x = 16.6 microgram/100 ml), the endogenous depressives (-x = 14.8 microgram/100 ml), and the depressed neurotics (-x = 14.4 microgram/100 ml) are greater than that of the controls (-x = 10.0 microgram/100 ml). In the evening the means of the nondepressed neurotics (-x = 8.8 microgram/100 ml), the manics (-x = 6.4 microgram/100 ml), and the endogenous depressives (-x = 7.0 microgram/100 ml) are greater than that of the controls (-x = 3.6 microgram/100 ml); also, the mean of the nondepressed neurotics (-x = 8.8 microgram/100 ml) is greater than those of the depressped neurotics (-x = 4.9 microgram/100 ml) and the schizophrenics (-x = 4.4 microgram/100 ml). The results are compared with the literature. The interpretation of the findings is problematic: probably unspecific factors of stress and specific factors of illness--at least in depressive illness of the endogenomorphic type--are relevant.

[Catamnestic results of 64 patients--5 years following inpatient psychosomatic treatment]. / Katamneseergebnisse von 64 Patienten--5 Jahre nach der stationären psychosomatischen Behandlung.

The present study is an attempt at evaluating with clinocosomatic, psychodiagnostic, and sociologic instruments the alterations achieved by (psychodynamically oriented) psychosomatic in-patient therapy. Out of a total of 64 patients who in 1975 had undergone treatment for an average period of two months 46 (i. e. 76.7 per cent) were available for re-examination after a five-year interval. In two thirds of the patients the various complaints and the general autonomic instability had receded. The psychical and social situation had improved for between two thirds and three fourths of all re-examined patients both in their own opinion and in that of other people. Correspondingly there was a significant reduction in consultations at the physician's as well as days of disability and days of hospitalization per year. Factors contributing to a favourable diagnosis were: low age of the patient, short duration of complaint, substantial stress induced by the disease, and long-term in-patient treatment.

[Simultaneous diagnosis and simultaneous therapy in a clinical-psychosomatic station]. / Simultandiagnostik und Simultantherapie auf einer klinisch-psychosomatischen Station.

According to modern understanding, bodily, spiritual and social symptoms are seen as the expression of a kind of transmissive disturbance. One could just as well speak of a disturbance in the cybernetic control systems. In this context we understand simultaneous diagnostics and therapy as a proper technique for the understanding and treatment of psychosomatic illnesses. In simultaneous diagnostics and therapy, it is not a matter of adding-up the various symptoms, but rather a matterof an independent method of integrating the various areas. As can be seen in a statistical evaluation of the patients in the clinical psychosomatic station in 1975, a few characteristic tendencies could be traced. By a listing of the frequency of complaints and the correlation with somatic findings, a somatic diagnosis could be found in 60% of the patients. With 36% of the patients no definite connection could be found between the somatic diagnosis, that is the clinical diagnosis, and the main complaints. Besides that, the duration of the symptoms was determined. Important new viewpoints were found in the psychological area in a total of 27 patients and in the somatic area in a total of 19 patients.