Psychosomatic Factors in the Rate of Recovery from Tuberculosis

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Abstract
The results of this exploratory study suggest that tuberculosis patients who show a more rapid rate of recovery during the early stages of hospital treatment can be distinguished from the slower recoverers on the basis of age, acuteness of illness, stage of treatment, and body type. The fast recoverers tend to be younger, are more acutely ill, are in the initial phases of treatment, and have body builds classified as mesomorphic or ectomorphic rather than endomorphic. Although fast and slow recoverers do not differ significantly in regard to race, extent of illness (far-advanced, moderate, or minimal involvement of infected lung tissue), or duration of illness, a number of personality, attitudinal, and ward-behavior factors distinguish the two groups. The rapid recoverers, in contrast to the slow recoverers, are inclined to be more enthusiastic, more confident and optimistic about the future, more socially outgoing, more overtly aggressive, and less preoccupied with their physical ailments or emotional problems. Slow recoverers are more depressed, hypochondriacal, self-preoccupied, and socially withdrawn. Speed of recovery was generally not related in a significant way with psychiatric diagnosis, although schizoid individuals were prone to be slow recoverers, whereas aggressive personalities improved more rapidly. Patients who were rated by nurses as being “good, cooperative” patients showed a slower rate of recovery than those rated as nonconforming and recalcitrant in daily ward behavior. The above findings tend to confirm previous clinical reports which have associated fast recovery among both tuberculosis and cancer patients with the overt expression of hostility, while slow recovery occurs more readily among patients who bottle up their anxiety and superficially appear to be “good” patients. In addition, the results give credence to old folk notions that hope and faith in recovery are assets in the treatment of physical illnesses, while despair and depression serve to prolong the disease.

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