Emotional Antecedents of Perforation of Ulcers of the Stomach and Duodenum

Castelnuovo-Tedesco, Pietro

doi:10.1097/00006842-196200700-00010

Cited by 16 publications

(5 citation statements)

References 56 publications

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“…A popular psychoanalytical theory around the 1950s was that ulcer patients typically had a “conflict situation” associated with a marked dependency 16 . Furthermore, Crohn reported a series of cases in which recurrence of ulcer symptoms or complications followed immediately after severe psychic trauma, 17 and Castelnuovo‐Tedesco reported a consecutive series of ulcer perforations “which usually occurred as a climax to a period of emotional turbulence” 18 . However, the literature up to that time was uncontrolled and the evidence at best hearsay.…”

Section: The Psychosomatic Theorymentioning

confidence: 99%

The ulcer sleuths: The search for the cause of peptic ulcers

Yeomans

2011

J of Gastro and Hepatol

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The search for the cause or causes of peptic ulcers has been a long one. It was recognised as early as the 19th Century that damage to the stomach or duodenal bulb was likely to result if the resistance of their mucosae to luminal acid was for some reason impaired. An early theory suggested microscopic vascular occlusion leading to local infarction could be the initiating event but evidence was lacking. Excessive acid secretion is seen in some patients but not in many so is implausible as the main factor in most ulcers. Cigarette smoking is a risk factor and chronic life difficulties has been shown to sometimes play a part, but we would now think that they play only minor roles to possibly tip the balance when a major etiologic factor is already present. The overwhelming evidence now is that the major etiologic factors in chronic peptic ulcer are ingestion of nonsteroidal antiinflammatory drugs (NSAIDs) and infection with Helicobacter pylori. Understanding the mechanism of the first, and the discovery and demonstration of Koch's postulates for the second, have been instrumental in the award of two Nobel prizes.

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Section: The Psychosomatic Theorymentioning

confidence: 99%

The ulcer sleuths: The search for the cause of peptic ulcers

Yeomans

2011

J of Gastro and Hepatol

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“…5,1966 eighth and sixteenth weeks of basic training. The concentration of pepsinogen in the serum was determined in each of them.…”

Section: Predictive Studiesmentioning

confidence: 99%

“…5,1966 clarification of important psycho-physiologic mechanisms. Application of psychopharmacological agents to psychosomatic research is a field that has hardly been touched by systematic investigation.…”

Section: Summary Conclusion and Perspectivesmentioning

confidence: 99%

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Recent Developments in Psychosomatic Medicine

Wittkower

Lipowski

1966

Psychosomatic Medicine

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A review of the major developments and trends in psychosomatic medicine during the last 5 years is presented. A similar review covering the preceding 2 decades is briefly summarized and used as a frame of reference for the analysis. This survey is largely confined to papers published in PSYCHOSOMATIC MEDICINE. It is found that psychiatrists continue to contribute most of the relevant research, but there is increasing participation by psychologists and other scientists. One notes a shift from clinical observation to laboratory research and from retrospective psychodynamic reconstructions to phenomenological description of behavior in more or less clearly defined experimental situations. Methodology has focused on experimental replication of psychological stress by a variety of means and the study of various physiological variables as presumed indicators of such stress. There has been a notable decline of theoretical speculation regarding psychological antecedents of somatic change and disease. Predictive studies of psychosomatic relationships have been undertaken in several areas. There is a new interest in the frequency, nature, and possible sociocultural determinants of psychosomatic disorders in non-Western societies. In general, psychosomatic medicine has continued to flourish as a science rather than as a clinical discipline. Sweeping generalizations regarding the nature and influence of psychological variables in the causation of bodily disease which characterized the earlier phase of psychosomatic medicine have largely been replaced by sober research design and low-level hypotheses. The assets and dangers of this shift are discussed, future trends in research interests are predicted, and promising areas for exploration suggested.A N PSYCHOSOMATIC MEDICINE, as in any research interests and allows one to make other area of scientific endeavor, there tentative predictions about future deis need for periodic stocktaking involv-velopments. Furthermore, one feels ening a review of what seem to be siinifi-couraged to suggest which kinds of probcant advances in research methodology lems could be profitably explored. The and in the formulation of hypotheses as present review covers the period of the well as in attempts at their validation, last 5 years and thus supplements an Such a survey reveals current trends in earlier similar publication 1 which sur-" From the Allan

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“…Certainly, the notions of lack of protection and lack of social support are consistent with the formulations of the circumstances under which this disease is likely to develop (Kapp et al, 1947;Wiener et. al., 1957;Alexander, 1934;Castelnuovo-Tedesco, 1962). From a theoretical standpoint, the important thing to recognize is that if there is a causal chain here, it is via an interaction of such host factors as pepsinogen level and personality with a specific and relevant environmental situation.…”

mentioning

confidence: 99%