Psychiatric Aspects of Vagotomy

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Abstract
Psychiatric studies were carried out on 25 patients with peptic ulcer treated by vagotomy. The patients were followed for an avg. of 1 yr. after operation. A detailed anamnesis was obtained from each patient. The disappearance of ulcer symptoms after vagotomy was often accompanied by the re-emergence of symptoms which the patient had earlier used as defense mechanisms. Given sufficient information about the patient, postoperative symptoms can usually be understood in terms of his personality structure. Patients who improved most after vagotomy shared the following characteristics: The preceding illness had not hindered their work, in which they were successful; there had been a history of few other illnesses; the ulcer symptoms began with a major stress in the patient''s life; there was no undue dependence on diet and medication, and no secondary gain from the illness. The characteristics of those ulcer patients who did not improve after vagotomy were just the opposite from those cited above. Illustrative medical and psychiatric case histories of 4 patients are included.

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