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Psychosomatic Medicine 11:25-29 (1949)
© 1949 American Psychosomatic Society

Physiologic Study of Symptom Mechanisms in Psychiatric Patients Under Stress

ROBERT B. MALMO PH.D.1 and CHARLES SHAGASS M.S.1

1 Allan Memorial Institute of Psychiatry, McGill University, Montreal, Canada

Physiologic recordings were taken from 74 mental patients in an experimental stress situation, consisting of a standard series of painful stimulations, presented by a Hardy-Wolff thermal stimulator. Patients were classified with respect to the presence or absence in the clinical history of 1) cardiovascular complaints, and 2) head and neck pains. The physiologic battery included recordings of: heart rate, respiration, and neck muscle potentials which are known to be related to the symptoms considered. The physiologic reactions of the patients, with and without each type of symptom, were then compared.

Results were as follows: a) Mean heart rate, mean heart rate variability, and median respiratory variability were all reliably greater for the group of patients with cardiovascular complaints. b) Muscle potential scores were reliably higher for the group of patients whose symptoms included complaints of head and neck pains. c) There was no reliable difference in muscle score between patients with cardiovascular complaints and those without such complaints. d) Nor were there any reliable differences in heart rate or respiration scores between patients with head and neck complaints and those without such complaints. e) At the time of testing, only 7 patients presented any of the complaints studied.

It was concluded that psychiatric patients with somatic complaints tend to manifest increased physiologic responsiveness in the related physiologic system or mechanism, upon exposure to stress. The disturbance appears specific to the physiologic system associated with the complaint, and can be demonstrated objectively even though the subjective symptom is not experienced at the time of stress.




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H. K. BEECHER
Generalization from Pain of Various Types and Diverse Origins
Science, July 31, 1959; 130(3370): 267 - 268.
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