Psychiatric Aspects of Somatic Immunity: Differential Incidence of Physical Disease in the Histories of Psychiatric Patients

There have been few studies in the past of the incidence of physical disease in the mentally ill relative to that of the general population. Many writers have pointed to the concurrent or subsequent development of such disorders as pulmonary tuber- culosis or enteric fever during the sojourn of psychiatric patients in mental hospitals, and there are a considerable number of reports from physicians concerning the intercurrence of mental symptoms in a variety of infections, traumata, tumours, intoxications, and other stressful experiences. This latter literature has been referred to in another communication (Lovett Doust, 1952), and an assessment of physical disorders present in patients admitted to a mental hospital has been made by Phillips (1937). In addition to these observations, a small number of studies have been concerned with the relative frequency of physical complaints in neurotically disturbed patients (Eysenck, 1947), with the length of convalescence of psychiatric patients afflicted by various bodily illnesses (Brodman and others, 1947a), and with the increased tendency of apparently mentally healthy patients hospitalized for physical illness to show neurotic scores on a psychological test (Cornell Service Index) as compared with other subjects who had not broken down (Brodman and others, 1947b). The current interest in the general adaptation syndrome of Selye (1950), as it affects the capacity for homeostatic adaptation of mentally-ill patients (Hoagland and Pincus, 1950) has been extended into the field of immunity, especially by the work of Dougherty and others (1945) on changing lymphocyte counts, these cells being thought to be concerned in immunity production (White and Dougherty, 1946).