Psychosomatic disorder: a treatment problem more difficult than neurosis? A comparative clinical study of psychosomatic and neurotic patients of the psychiatric policlinic of a general hospital.

Two patient groups from the psychiatric policlinic of a general hospital were compared, the first comprised 93 patients with severe psychosomatic disorders who were not diagnosed as neurotic, and the second, 133 neurotic patients without psychosomatic symptoms. The aim of the study was to clarify anamnestic and personality differences between the groups and investigate their treatment motivation. The psychosomatic patients showed less motivation for psychiatric treatment, even though their psychiatric impairment was more severe than that of the neurotics and although the extent of their psychological symptoms was equally great. Compared with the neurotic patients, the ability to tolerate stress was poorer and the attitude toward the interview and the interviewer was more defensive in the psychosomatic patients. Compared with the neurotics, medical services were utilized to a greater extent by the psychosomatic patients, and their childhood environment and background development were characterized by somewhat more psychological disturbance.