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Continuing Incapacity Despite "Medical Recovery"

Milton H. Miller, M.D.
[+] Author Affiliations

Presented at the Annual Meeting of the Ohio Medical Association, May, 1960.


Madison, Wis.

Associate Professor of Psychiatry, University of Wisconsin.


JAMA. 1961;176(3):205-207. doi:10.1001/jama.1961.03040160025004
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The physician not infrequently encounters patients who have achieved good medical or surgical recovery but fail to return to a life of useful activity. Such patients show a continuing incapacity despite "medical recovery." This is especially likely to occur after illnesses that immobilize the patient and make him dependent upon others for his care. His relation to the physician and the physician's understanding and interest strongly influence the results. The histories of 2 male patients aged 44 and 37 years illustrate these principles. It is recommended that discharge planning begin at the time of the physician's first interview with the patient and that measures to keep the patient alert, stimulated, and self-confident be considered, especially if treatment involves long periods of immobilization.

REFERENCES

Greenfield, N. S.; Roessler, R.; and Crosley, A. P., Jr.:  Ego Strength and Length of Recovery from Infectious Mononucleosis , J Nerv Ment Dis 128:125-128 ( (Feb.) ) 1959;.
Roessler, R., and Greenfield, N. S.:  Incidence of Somatic Disease in Psychiatric Patients , Psychosom Med : To be published.
Klopfer, B.:  Psychological Variables in Human Cancer , J Project Tech 4:331-340 ( (Dec.) ) 1957;.
Blumberg, E. M.; West, P. M.; and Ellis, F. W.:  Possible Relationship Between Psychological Factors and Human Cancer , Psychosom Med 16:277-286 ( (July) -Aug.) 1954;.
Doust, J. W. L.:  Psychiatric Aspects of Somatic Immunity: Differential Incidence of Physical Disease in Histories of Psychiatric Patients , Brit J Pren Soc Med 6:49-67 ( (Jan.) ) 1952;.
Schmale, A. H., Jr:  Relation of Separation and Depression to Disease , Psychosom Med 20:259-277 ( (July) -Aug.) 1958;.
Berle, B. B.:  Emotional Factors and Tuberculosis: Critical Review of Literature , Psychosom Med 10:366-373 ( (Nov.) -Dec.) 1948;.
West, L. J.:  Psychiatric Aspects of Training for Honorable Survival as Prisoner of War , Amer J Psychiat 115: 329-336 ( (Oct.) ) 1958;.
Farger, I. E.; Harlow, H. F.; and West, L. J.:  Brainwashing Conditioning and DDD (Dependency, Debility and Dread) Sociometry 4:271-285 ( (Dec.) ) 1957;.
Luby, E. D., and others:  Sleep Deprivation: Effects on Behavior, Thinking, Motor Performance, and Biological Energy Transfer Systems , Psychosom Med 22:182-192 ( (May) -June) 1960;.
Slocum, J.: Sailing Alone Around World , London: Hart-Davis, 1948;.
Heron, W.; Bexton, W. H.; and Hebb, D. O.:  Cognitive Effects of Decrease Variation to Sensory Environment , Amer Psychol 8:366 ( (Aug.) ) 1953;.
Lilly, J. C.:  Mental Effects of Reduction of Ordinary Levels of Physical Stimuli on Intact, Healthy Persons , Psychiat Res Rep Amer Psychiat Ass ( (June) ) 1956;, pp. 1-28.
Miller, M. H.:  Compensation Neurosis , J Forensic Sci 4:159-166 ( (April) ) 1959;.
Miller, M. H.:  Borderline Pschotic Patient: Importance of Diagnosis in Medical and Surgical Practice , Ann Intern Med 46:736-743 ( (April) ) 1957;.
Miller, M. H.; Fellner, C. H.; and Greenfield, N. S.:  Depression, Suicide and Suicidal Gesture in Medical Practice , Ann Intern Med 51:78-88 ( (July) ) 1959;.
Rogers, C. R.:  Necessary and Sufficient Conditions of Therapeutic Personality Change , J Consult Psychol 21:95-103 ( (April) ) 1957;.
Rehabilitation Record , vol. 1, no. (6) ., United States Department of Health, Education and Welfare, Office of Vocational Rehabilitation (Nov.-Dec.) 1960;.

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Greenfield, N. S.; Roessler, R.; and Crosley, A. P., Jr.:  Ego Strength and Length of Recovery from Infectious Mononucleosis , J Nerv Ment Dis 128:125-128 ( (Feb.) ) 1959;.
Roessler, R., and Greenfield, N. S.:  Incidence of Somatic Disease in Psychiatric Patients , Psychosom Med : To be published.
Klopfer, B.:  Psychological Variables in Human Cancer , J Project Tech 4:331-340 ( (Dec.) ) 1957;.
Blumberg, E. M.; West, P. M.; and Ellis, F. W.:  Possible Relationship Between Psychological Factors and Human Cancer , Psychosom Med 16:277-286 ( (July) -Aug.) 1954;.
Doust, J. W. L.:  Psychiatric Aspects of Somatic Immunity: Differential Incidence of Physical Disease in Histories of Psychiatric Patients , Brit J Pren Soc Med 6:49-67 ( (Jan.) ) 1952;.
Schmale, A. H., Jr:  Relation of Separation and Depression to Disease , Psychosom Med 20:259-277 ( (July) -Aug.) 1958;.
Berle, B. B.:  Emotional Factors and Tuberculosis: Critical Review of Literature , Psychosom Med 10:366-373 ( (Nov.) -Dec.) 1948;.
West, L. J.:  Psychiatric Aspects of Training for Honorable Survival as Prisoner of War , Amer J Psychiat 115: 329-336 ( (Oct.) ) 1958;.
Farger, I. E.; Harlow, H. F.; and West, L. J.:  Brainwashing Conditioning and DDD (Dependency, Debility and Dread) Sociometry 4:271-285 ( (Dec.) ) 1957;.
Luby, E. D., and others:  Sleep Deprivation: Effects on Behavior, Thinking, Motor Performance, and Biological Energy Transfer Systems , Psychosom Med 22:182-192 ( (May) -June) 1960;.
Slocum, J.: Sailing Alone Around World , London: Hart-Davis, 1948;.
Heron, W.; Bexton, W. H.; and Hebb, D. O.:  Cognitive Effects of Decrease Variation to Sensory Environment , Amer Psychol 8:366 ( (Aug.) ) 1953;.
Lilly, J. C.:  Mental Effects of Reduction of Ordinary Levels of Physical Stimuli on Intact, Healthy Persons , Psychiat Res Rep Amer Psychiat Ass ( (June) ) 1956;, pp. 1-28.
Miller, M. H.:  Compensation Neurosis , J Forensic Sci 4:159-166 ( (April) ) 1959;.
Miller, M. H.:  Borderline Pschotic Patient: Importance of Diagnosis in Medical and Surgical Practice , Ann Intern Med 46:736-743 ( (April) ) 1957;.
Miller, M. H.; Fellner, C. H.; and Greenfield, N. S.:  Depression, Suicide and Suicidal Gesture in Medical Practice , Ann Intern Med 51:78-88 ( (July) ) 1959;.
Rogers, C. R.:  Necessary and Sufficient Conditions of Therapeutic Personality Change , J Consult Psychol 21:95-103 ( (April) ) 1957;.
Rehabilitation Record , vol. 1, no. (6) ., United States Department of Health, Education and Welfare, Office of Vocational Rehabilitation (Nov.-Dec.) 1960;.
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