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April 7, 1956


Author Affiliations


From the departments of surgery and psychiatry, University of Cincinnati College of Medicine. Dr. Zwerling is now in the Department of Psychiatry, Albert Einstein College of Medicine, New York.

JAMA. 1956;160(14):1187-1193. doi:10.1001/jama.1956.02960490001001

• The reasons for procrastination in seeking professional attention were studied in 200 surgical patients. In 23 cases the patient had no opportunity to delay because he entered the hospital comatose or was brought in immediately after a serious accident, and in 11 cases information was insufficient. Of the 166 patients who did have opportunities to delay, 71 were classified as having done so in the sense that they had ignored obvious alterations of somatic structure or function that would have caused concern to a rational person in the patient's cultural milieu.

Nondirective interviews, projective tests, casework data, and follow-up studies in the 71 procrastinators revealed no significant differences between them and the other patients as to age, sex, intelligence, or psychiatric diagnosis. The findings did, however, support the hypothesis that delay results from a multiplicity of conscious and unconscious psychological factors operating before, during, and after the patient recognizes a sign or symptom. Cancer and disease in the genital area were frequent occurrences in the group who delayed. The complexity and difficulty of the problems faced by some patients are illustrated by details from a number of case histories.