Psychosomatic Medicine 16:41-46 (1954)
© 1954 American Psychosomatic Society

Psychosomatic Correlations in Certain Blood Dyscrasias

¹ Departments of Medicine and Psychiatry, George Washington University School of Medicine Washington, D.C.

Eight patients with idiopathic thrombocytopenic purpura, 2 with familial spherocytosis, and 5 with sickle-cell anemia were studied by psychiatric interviews and, when possible, by Rorschach tests, to learn if there might be a temporal correlation between emotional stress and bleeding in thrombocytopenic purpura, and between emotional stress and hemolytic crises in the anemias.

In 5 of 8 patients with thrombocytopenic purpura, the onset or reactivation of the disease followed a prolonged period of psychic stress. This often involved the actual loss or threatened alienation of the mother or a mother figure. The patient frequently reacted to this situation with guilt as he unconsciously blamed his own hostility for it.

In 3 other patients with thrombocytopenic purpura, as well as in 2 of the first group, sudden increased bleeding in the active stage of the disease or spontaneous bruising in the quiescent phase occurred in eleven instances in the wake of an upsetting experience.

One crisis and one episode of sudden sharply increased hemolysis in the patients with spherocytosis, and seven of sixteen crises in the patients with sickle-cell anemia took place ten hours to three days after the onset of a distressing emotional experience.

Several mechanisms which could explain some of these observations are discussed.