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A thorough physical and psychological study of a group of some four hundred twelve tubercular patients in a Veterans Administration Hospital resulted in a division of this group into so-called fast and slow recoverers. After other variables were eliminated, the study revealed two significant clusters. The group of fast recoverers were those patients not considered to be good patients but rather those who tended to be openly aggressive and rebellious and who maintained an affirmative attitude toward their recovery. By contrast the slow recoverers were those who tended to be schizoid and/or depressed and were classified as coöperative due to their conforming attitudes, submissiveness, and relative undemandingness. Steroid factors seemed to be a significant element in the difference between these two groups.
The findings would also seem to corroborate Freud's works on masochism, narcissism, and depression, relating self-directed instinctual energies (primarily aggressive) to illness and, ultimately, to death. It also correlates interestingly with Sheldon's interpretation of body types in that mesomorphy and ectomorphy predominated in the fast recoverers whereas endomorphy usually led to a poor prognosis. The predominance of oral dependent traits in endomorphy has been noted by contrast with the more active aggressive outward-turning traits associated with mesomorphy and ectomorphy.
A similarity between these results and those of a study of patients with metastatic breast cancer is noted. Hope, faith, and an optimistic attitude appear to go a long way toward speeding recovery in tuberculosis and, in fact, appear to influence favorably even the course of terminal illness.