[Comparative studies of the personality structure of the diabetic patient and the patient with chronic liver disease].

Not only does the psychological pressure of suffering from a chronic and in most cases incurable disease have a major impact on the patient's mind; it has also to be assumed that it is rather the mental predisposition which contributes to the manifestation of an organic disease and its becoming chronic. Studies of insulin-depending diabetics have shown that with two thirds of the patients there had been a mental conflict which they were unable to cope with prior to the manifestation proper of this metabolic disorder. With type-II diabetics it is an unsurmounted feeling of anxiety and guilt which makes patients break off their interhuman relations and leads, in most cases, to obesity and, eventually, to the manifestation of the disease. Adolescent diabetics who accept the disease as part of their lives once they have overcome their initial feelings of inferiority and recovered a certain mental equilibrium, develop an optimistic and predominantly life-affirming character and tend to restore the self-confidence they had lost. The situation is different with type-II diabetics who, even if the disease has been completely integrated into their lives, will show a basically depressive mood with a distinct lack of open-mindedness and self-criticism. Patients who suffer from a chronic hepatic disease can be characterised by a pronounced hypochondriac and anxious mood which is apparent even before the outbreak of an acute hepatocellular disorder or, at least, before this disease becomes chronic. From the psychological point of view, these persons reveal a marked depressive personality with a neurotic element in it which shows in the course of the disease and even after it has been cured or stopped. As a result, these patients often retire prematurely from their jobs. On the other hand, diabetics will not give up their professional activities unless they are forced to do so because of organic complications or delayed diabetic effects.