JAMA. 1962;181(6):549-550. doi:10.1001/jama.1962.03050320087007.
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That ulcerative colitis patients are frequently depressed is a common observation made by clinicians. Usually the depression is attributed to the severe debilitating effects of the somatic process. However, clinical studies of the illness, such as the one which appears in this issue, p. 463, present another way of examining this depression which has implications for the evaluation and management of ulcerative colitis patients. It is pointed out that depression and bleeding from the colonic mucosa are concomitant but separate responses that predisposed individuals have when subjected to real or phantasied object loss. This depression may be deepened as the somatic process becomes more extensive. However, to view it as entirely secondary to toxic factors is to miss the meaning that the precipitating stress has for the patient and the elements that the physician should try to establish in his relationship with the patient. It is important that the patient's


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