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April 1967

Corticosteroid Responses to Psychotherapy of DepressionsI. Evaluations During Confrontation of Loss

Author Affiliations

From the Psychoendocrine Research Laboratory and the Center for Clinical and Metabolic Studies of Affective Disorders, Massachusetts Mental Health Center, and the Department of Psychiatry, Harvard Medical School, Boston.

Arch Gen Psychiatry. 1967;16(4):461-470. doi:10.1001/archpsyc.1967.01730220073011

THIS PAPER will report psychological and endocrinological observations on six hospitalized female patients receiving Psychotherapy for depressive reactions.

The study was designed to test endocrinologically a familiar psychiatric formulation first proposed by Freud in 1917:1 one type of depressive reaction is regarded as precipitated by a loss, defined as a loss of a loved object or ideal. The patient responds initially with affective distress, and then goes on to form a pathological symptom syndrome in which, for example, self-recrimination may be a prominent feature, but in which the painful loss is not affectively acknowledged. Many of the depressive symptoms which the patient forms may be regarded as serving, in part, defensive or restitutive functions, in that these symptoms operate to help the patient avoid experiencing the painful loss. It is this type of depressive reaction which was well described by Freud, Abraham,

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