Emotional Reactions to Long-Term Anticoagulation

John A. Udall, MD
JAMA. 1965;191(10):865. doi:10.1001/jama.1965.03080100083029.
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To the Editor:—  Our observations of patients' emotional reactions to long-term anticoagulant therapy are essentially opposite to those cited in the editorial. It seems possible that the responses were artifacts of an excessive discussion of anticoagulation therapy in a small clinic and the presence of a psychiatrist-observer at regular clinic visits.The near-magic perception of this therapy is uncommon. Most patients learn little beyond the blood-thinning idea and the need to watch for bleeding. They usually want only the simple facts—how many pills to take and how often the blood is to be tested—and most do not invest the subject with magical thinking and rich emotional interest. Our patients assign more magical powers to nitroglycerin than to the coumarin drugs, for obvious reasons. And this matter of factly, rather than with emotional preoccupation, even though these pills may be just as explosive.Most of our patients accept coumarin dose changes


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