Psychological Factors in the Etiology of Pulmonary Tuberculosis, and in the Causation of Relapse

Kissen, David M (1955) Psychological Factors in the Etiology of Pulmonary Tuberculosis, and in the Causation of Relapse. PhD thesis, University of Glasgow.

Abstract

No investigation using controls has hitherto been carried out into emotional factors preceding the onset or relapse of cases of pulmonary tuberculosis. Only one investigation, using controls, into premorbid tuberculous personality type has been carried out and the results of this were negative. In the series of three Investigations described, control cases were used and all the results subjected to statistical testing. The material, methods and conditions of the Investigations are described in detail. These show the care that has been taken to ensure unbiased results. All the cases, tuberculosis and controls, were unselected. The total number of cases included in the First Investigation - into Emotional Factors preceding Onset - is 198. Of these 64 were subsequently diagnosed as suffering from pulmonary tuberculosis. The remaining 134 controls included 46 who had no abnormality and 14 who had psychosomatic affections. The number of cases included in the Second Investigation - into Emotional Factors preceding Relapse - is 194, of whom 73 had relapsed. The other 121 were used as controls. In addition, there were 20 'chronics', described in the Appendix. 69 patients are included in the Third Investigation and 24 of these were subsequently found to have pulmonary tuberculosis, the remainder being the controls. The findings of this Investigation are used to corroborate the findings of the First Investigation. An unselected 45 of these patients are used In a modified investigation into personality trait, 20 subsequently proving to be tuberculous and the remaining 25 acting as controls. The importance of psychological assessment of the patient and his family is stressed. Some possible methods of psychological treatment are mentioned - short term exploratory abreactive methods, 'superficial psychotherapy' and 'anaclitic therapy' with a psychoanalytical basis. The place of the sanatorium in treatment is discussed and attention drawn to the Breaks in Love Links both to the patient and his family -especially children - caused by removal of a patient from his home. Since in many cases home treatment may be as effective as sanatorium treatment, the dangers of infection to others must be carefully weighed against the dangers of psychological trauma to the patient or other members of the family - unless there are definite indications for sanatorium treatment. The chief indications for sanatorium are - (i) Special treatment (e. g. , surgery or collapse) necessitating admission; (ii) Poor home conditions; (iii) Unfavourable psychological background. Likewise, the wisdom of segregation for the purposes of B. C. G. vaccination is questioned. (Abstract shortened by ProQuest.).

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: Medicine, Epidemiology, Microbiology
• Date of Award: 1955
• Depositing User: Enlighten Team
• Unique ID: glathesis:1955-79150
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 05 Mar 2020 11:38
• Last Modified: 05 Mar 2020 11:38
• URI: https://theses.gla.ac.uk/id/eprint/79150