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April 14, 1962

Bodily Complaints and Other Symptoms of Depressive Reaction: Diagnosis and Significance in a Medical Clinic

Author Affiliations


Associate in Medicine, Harvard Medical School, and Assistant Physician, Massachusetts General Hospital (Dr. Stoeckle); Assistant in Psychiatry, Harvard Medical School and Massachusetts General Hospital (Dr. Davidson).

JAMA. 1962;180(2):134-139. doi:10.1001/jama.1962.03050150040008

Medical clinic patients with "functional" bodily complaints were commonly found to have a depressive reaction. This reaction consists of bodily symptoms and disturbances in relations, both interpersonal (withdrawl, irritability, and resentment) and intrapersonal (depressed mood, loss of pleasure in usual activities, helplessness, and injured self-esteem). The diagnosis is made on the history of a traumatic event which the patient perceives as a loss, rather than on symptoms alone. Diagnosis is important because the bodily symptoms are commonly used as a reason for coming to the doctor, because care of the patient demands recognition of all aspects of his illness, and because rational treatment depends on it. Treatment involves several roles of the doctor and his explicit or implicit use of some psychotherapeutic techniques in his medical practice. Four case histories illustrate these principles.