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November 9, 1946


Author Affiliations

San Francisco

JAMA. 1946;132(10):555-557. doi:10.1001/jama.1946.02870450009002

It is conservatively estimated that 50 per cent of all cases seen in general medical clinics are primarily psychiatric problems, most of which would be labeled neuroses. A prominent cardiologist has stated that over half the cases referred to him are cardiac neuroses and not organic heart disease. If, then, the neuroses are seen so frequently in all fields of medicine, it seems desirable to present a paper on the subject before this audience.

There is no commonly accepted definition of the term neurosis. Some of the older writers differentiated carefully between the neuroses, which were considered organic diseases with a definite physical basis, and psychoneuroses, which were thought to be of mixed origin with the psychologic factors regarded as the more important ones. Beard described neurasthenia as due to an organic nervous exhaustion.

Freud originally separated the true neuroses, which he felt were physiologic in origin. In his earlier

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