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Weinstein and Kahn continue previous studies on the phenomenon of denial of illness. The authors compare the premorbid personalities of twenty-eight patients with brain disease who explicitly denied illness, with a group of twenty-eight patients with comparable disabilities but without explicit verbal denial.
The patients with verbal denial were generally persons with strong compulsive drives, a great need for prestige and the esteem of others, and a general attitude of unconcern and denial of inadequacies. They showed the opposite of hypochondriasis, having always regarded illness as an imperfection or weakness. In contrast, the premorbid personalities of the control group showed a greater variability and no single consistent pattern. The authors feel that brain disease does not cause denial but rather creates a milieu in which new ways for its expression can be evolved. The particular kind of denial used, whether explicit verbal denial or such implicit forms as humor, muteness, motor overactivity, or drowsiness, depend mainly on personality. The aim of such procedures as lobotomy seems to be the production of a state of explicit verbal denial.