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Article
September 24, 1927

PSYCHIC FACTORS IN THE COURSE OF CARDIAC DISEASE

JAMA. 1927;89(13):1017-1018. doi:10.1001/jama.1927.02690130005003
Abstract

Under the term of psychic disorders I wish to be understood to include not only the more obvious disorders of intelligence and reason but also the less clearly defined changes in personality that determine in life the relation an individual holds with his environment. Thus defined, the psychic disorders that are initiated not only by real heart disease but also scarcely less by imagined disease are various and important. In concrete cases we find at one extreme clearly defined examples of organic mental reaction due to cerebral congestion or anemia or to toxic states resulting from cardiovascular failure, and at the other a pathetic failure of adaptation due to personality or constitutional defects but not necessarily an inferiority complex.

In severe states of cardiac insufficiency, sleep is disturbed and broken by periods of semiconsciousness. During this period some patients are subject to dreams in the sleeping period and hallucinations in

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