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My experience of patients with duodenal ulcer is based so far on four groups studied by the following methods:
i.51 male patients selected from a medical department and compared with a corresponding number of controls without gastro-intestinal complaints. All had psycho-analytically-oriented interviews and various psychological tests (1958);
ii.48 male patients admitted a total of 212 times to psychiatric departments where they had been examined clinically by a number of different psychiatrists (1959);
iii.24 female patients with a history of gastric resection five years previously, followed up by analytically-oriented interviews (to be published later);
iv.1 patient who has completed psycho-analytic treatment, 2 patients in psycho-analysis, and 28 treated by analytically-oriented psychotherapy.
Psycho-analysis is of course the necessary diagnostic method in radically ascertaining the psychosocial genesis, but a few psycho-analytically-oriented interviews (partially in relation to the revised answers to a special questionnaire) may be sufficient to evaluate the symptoms, the predominant personality traits, and the essential dynamic factors, presupposing that the analyst has sub-special psychosomatic training and of course that the patient affords positive co-operation. It may be mentioned that therapeutically effective insight is no absolute condition for a number of exact psychodiagnostic evaluations, no matter how much the best psychodiagnostic methods owe to psycho-analytic observations. Within present-day psycho-analysis there is an ever-increasing tendency to utilize to the full whatever adequate psychodiagnostic methods can yield before starting an analysis.
It may also be mentioned here that, although often disregarded, it is important to get really representative materials within psychosomatic studies generally, and in cases of peptic ulcer to differentiate sharply between duodenal and gastric ulcer.
According to the results of my studies of patients with duoden