Abstract
Ulcerative colitis is one of a loose group of “psychosomatic” or “psychophysiologic” diseases appearing together in our present official nosological classification. These illnesses share certain common features: the presence of tangible lesions and pathophysiology, the possibility of serious and fatal outcomes, association with certain mental states, and mediating mechanisms outside the voluntary nervous system. This paper is a discussion of the historical steps or criteria necessary to “establish” a disease entity as “psychosomatic”, illustrated by features of ulcerative colitis, the people who suffer from it, and their treatment.
The criteria of a psychosomatic disease, as presented, are: —
1. The association of life stresses with exacerbations of the disease.
2. The finding of generally disturbed personality types associated with sufferers from the disease.
3. Some specificity of personality traits in sufferers from the disease, traits which usually do not fall within any standard psychiatric diagnosis.
4. Some specificity of the type of life stress precipitating attacks of the disease in predisposed people.
5. Establishment of scientifically plausible connections between personality type, specific stress, mental state, and pathophysiologic reaction.
6. Evidence that a specific psychotherapeutic approach contributes to remission, over and above other treatment measures.