Psychosomatic Medicine 11:211-215 (1949)
© 1949 American Psychosomatic Society

Emotional Factors in the Precipitation of Recurrent Diabetic Acidosis

¹ Departments of Medicine, Psychiatry, and Preventive Medicine, Johns Hopkins University, School of Medicine

Twelve patients who had repeatedly been admitted to the hospital in diabetic acidosis were studied by psychiatric interviews and social-service casework. The failure of all of these patients to maintain diabetic regulation was due to abandonment of their diabetic regime. Direct influence of emotions upon metabolic processes could not be studied because of the patients' unreliability, but it could not have been more than a secondary factor. These patients were utilizing their diabetes as a means of escape either into the shelter of the hospital or through suicide. An attempt has been made to sketch some common features of the immature and poorly integrated personality structure of the patients as a group. The alterations in the therapeutic management induced by the study in an effort to forestall the self-destructive tendencies have been outlined. It is recognized that it is hazardous to draw generalizations from this group to apply to diabetics in general, for the problem seems to consist of the difficult task of treating patients who are both diabetic and also either psychotic or borderline psychotic.