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August 24, 1970

Open-Heart Surgery and The Psyche

JAMA. 1970;213(8):1343-1344. doi:10.1001/jama.1970.03170340065019

To the Editor.—  I do not believe your editorial "Open-Heart Surgery and the Psyche" (212:1370, 1970) accurately presents the prior body of work in this field or the data presented by Tufo and his associates in the excellent paper which stimulated the writing of the editorial.1 I have worked in the area of psychiatric complications of open-heart surgery for some time and do not believe that the literature reflects the theoretical dichotomy between psychogenic and organic etiology which your editorial writer describes. While some papers have emphasized psychogenic factors and others organic factors, most have acknowledged the postoperative reactions to be a complex interaction of many variables.Your editorial thus oversimplifies complex phenomena. It implies that all post cardiotomy psychiatric problems are, in effect, merely the product of brain damage produced during the operation. My concern is that the role of a variety of other factors may thus