A thorough knowledge of the patient's earlier life is required for an assessment of the background of Menitre's disease. Psychosomatic factors should be given special attention during interviews. For a correct picture to be obtained, the help of a specially trained worker i.e. a psychiatrist or psychologist, should be enlisted. Factors and casual relationships can then be uncovered which remain problems to doctors not thus specialized. The two series dealt with in this study illustrate this clearly. Summarizing the observations made, Menitre patients subjected to careful psychic and somatic analysis are found to have a predisposing psychosomatic constitution which, under chronic or acute stress, leads to such somatic manifestations as, in their turn, seem to presuppose a certain somatic predisposition-in this particular case evidently in the ear. Chronic stress seems to impair prognosis, a fact not difficult to understand considering that the mode of reaction depends upon the constitution, which-obviously-is of fairly permanent nature. Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only. Acta Otolaryng 7Q Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only. Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only.
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