Psychosomatic Correlations in Certain Blood Dyscrasias

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Abstract
Eight patients with idiopathic thrombocytopenic purpura, 2 with familial spherocytosis, and 5 with sickle-cell anemia were studied by psychiatric interviews and, when possible, by Rorschach tests, to lean if there might be a temporal correlation between emotional stress and bleeding in thrombocytopenic purpura, and between emotional stress and hemolytic crises in the anemias. In 5 of 8 patients with thrombocytopenic purpura, the onset or reactivation of the disease followed a prolonged period of psychic stress. This often involved the actual loss or threatened alienation of the mother or a mother figure. The patient frequently reacted to this situation with guilt as he unconsciously blamed his own hostility for it In 3 other patients with thrombocytopenic purpura, as well as in 2 of the 1st group, sudden increased bleeding in the active stage of the disease or spontaneous bruising in the quiescent phase occurred in 11 instances in the wake of an upsetting experience. One crisis and 1 episode of sudden sharply increased hemolysis in the patients with spherocytosis, and 7 of 16 crises in the patients with sickle-cell anemia took place 10 hrs. to 3 days after the onset of a distressing emotional experience. Several mechanisms which could explain some of these observations are discussed.

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