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Psychosomatic Medicine 33:1-30 (1971)
© 1971 American Psychosomatic Society

Psychologic Processes and Ischemic Stroke (Occlusive Cerebrovascular Disease)

I. Observations on 32 Men with 35 Strokes

ROLF ADLER MD1, KENNETH MACRITCHIE MD1, and GEORGE L. ENGEL MD2

1 Departments of Psychiatry and Medicine, University of Rochester School of Medicine Rochester, NY
2 Departments of Psychiatry and Medicine, University of Rochester School of Medicine Rochester, NY; Dr. Engel is a Career Research Awardee of the National Institute of Mental Health.

A retrospective anamnestic study of 32 men experiencing a total of 35 ischemic strokes revealed that the stroke typically occurred during a period of sustained or intermittent and often severe emotional disturbance which had been going on for weeks or months and which sometimes had become intensified shortly before the stroke occurred. Certain personality features were commonly represented, including a behavioral pattern, designated pressured, to assure satisfaction of selfset goals; chronic problems in the control of anger; and an object-relating style characterized by assumption of personal responsibility for gratification of needs. The typical setting in which the stroke occurred was one in which the patient was reacting with a feeling of anger, hopelessness and sometimes shame when he felt he was not performing up to his own standards, no longer was in control of his objects or of his environment, or no longer was meeting the needs of others.

The similarities between these characteristics and those previously reported for patients with coronary disease, hypertension and migraine are discussed.

Submitted on July 17, 1970




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Copyright © 1971 by the American Psychosomatic Society