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Autoerthrocyte sensitization---a psychogenic purpura?

There are two schools of thought regarding the pathogenesis of this syndrome. Gardner and Diamond and others demonstrated that these patients have a hypersensitivity to extravasated RBCs. They assumed that a fixed tissue antibody reacted with red blood cell stroma producing edema, increased capillary permeability, and further extravasation of blood into the tissues. Ratnoff, Agle, and others, however, believe the syndrome is a psychiatric disorder and that the ecchymotic lesions represent a form of conversion reaction--a mechanism that could explain the patient's myriad complaints. There is evidence that vascular beds are controlled by psychic processes. Neurogenically elaborated kinin-like agents might serve as humoral mediators between the central nervous system and the local tissue reaction.2,4,12 Regardless of the basic etiology, we think the syndrome is more common than has previously been considered and should be thought of in patients with recurrent purpuric eruptions of the extremities.

Adult

Psychotic reactions associated with childbirth.

The literature on postpartum psychoses is reviewed. Clinical similarities and differences between patients with postpartum psychoses and those with nonpuerperal psychoses are described. The psychological and physiological precipitants of postpartum psychoses are discussed and a stress summation theory is proposed to explain the etiology of these reactions. Treatment considerations and factors pointing to favorable short-term and long-term prognoses are reviewed.

Age Factors

The Klüver-Bucy syndrome in man.

It is apparent that the importance of the limbic system is essentially for survival. The inability to discriminate enemy from friend as well as loss of the proper affective response to what is dangerous or safe to the organism may be thought of as more central to survival than what is described as "other higher intellectual functions." The case described is a dramatic expression of such a transient limbic dementia originally described by Klüver and Bucy in their syndrome. Since Klüver and Bucy originally described their syndrome, the structural and functional understanding of the limbic system has been greatly increased. Although a rare occurrence in man, the Klüver-Bucy syndrome serves as a demonstration of an unusual brain syndrome whose theoretical and experimental basis has been greatly enlarged since first described.

Adult

[Psychosomatic aspects of pregnancy, parturition and puerperium (author's transl)].

Pregnancy, delivery and post-partum period represent not only a special physical strain, but also an extra-ordinary psychic stress. Defective developments and neuroses, especially in the sexual field, as well as improperly adjusted current conflicts, can lead to somatic disturbances. The present-day situation is particularly characterized by the dual role played by the modern woman in society, and the resulting ambivalence of her attitude toward maternity. Over and above this, the technicalization of modern medicine can be associated with a loss of the human relationship between the patient and the physician, so that the patient gets the impression of being at the mercy of an inhuman apparatus. Hence, it is one of the fundamental problems of modern obstetrics not to transgress the limits where technicalization defeats its own purpose and becomes more harmful than useful. Although it cannot be the aim of psychosomatic training in obstetrics and gynecology to train the gynecologist in such a manner that he can also practise formal psychotherapy, it will become more and more important in future to expand our traditionally biologically oriented method of working by the aspect of the interactional and psychosocial fields of life.

Female