Zeichen R
Wien Med Wochenschr Suppl. 1986;96:1-12.
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.
患有慢性且在大多数情况下无法治愈的疾病所带来的心理压力，不仅会对患者的心理产生重大影响；还可以假定，正是心理易感性促使了器质性疾病的显现及其慢性化。对依赖胰岛素的糖尿病患者的研究表明，三分之二的患者在这种代谢紊乱真正显现之前，就曾经历过无法应对的心理冲突。对于II型糖尿病患者来说，一种无法克服的焦虑和内疚感使他们断绝人际关系，在大多数情况下导致肥胖，并最终引发疾病。青少年糖尿病患者一旦克服了最初的自卑感并恢复了一定的心理平衡，将疾病视为生活的一部分，他们会形成乐观且主要是肯定生活的性格，并倾向于恢复他们失去的自信心。II型糖尿病患者的情况则不同，即使疾病已完全融入他们的生活，他们仍会表现出基本的抑郁情绪，明显缺乏豁达和自我批评精神。患有慢性肝病的患者，其特征是即使在急性肝细胞疾病爆发之前，或者至少在该疾病变为慢性之前，就表现出明显的疑病和焦虑情绪。从心理学角度来看，这些人表现出明显的抑郁人格，其中带有神经质成分，这种成分在疾病过程中乃至治愈或病情停止后仍会显现。结果，这些患者常常过早退休。另一方面，糖尿病患者除非因器质性并发症或糖尿病延迟效应而被迫放弃，否则不会放弃他们的职业活动。
