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August 11, 1962

A Clinical Study of Ulcerative Colitis

Author Affiliations

Los Angeles
From the Department of Psychiatry, The Neuropsychiatric Institute, UCLA School of Medicine.

JAMA. 1962;181(6):463-471. doi:10.1001/jama.1962.03050320001001

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This paper reevaluates the psychogenic explanations of ulcerative colitis in the light of experience with 47 cases. In 52 episodes in 40 patients it was judged that psychological stress interpreted as objectloss precipitated the bleeding. Both psychiatric evaluations and psychological testing showed a consistent panpsychopathology with a preeminence of depression. This study supports the thesis that ulcerative colitis occurs in persons with immature or defective egos after real or fantasied object loss and may be viewed as a morbid grief reaction. The panpsychopathology predisposes to a morbid reaction. The authors reject hypotheses which focus on particular aspects of the panpsychopathology in order to establish symbolic meaning for the somatic pathology or to link the illness to specific difficulties in the mother-child relationship during a circumscribed phase of development.