[Objectivization of psychosocial characteristics in chronic physical deformities. Example: Funnel chest--results of an integrative diagnosis]

In a thorough investigation of 164 characteristics (sequelae) in 41 patients with funnel chest, the fundamentals of a method for "integrating diagnosis" are presented. The symptoms "funnel chest" can be of varied significance, according to the degree of deformity, ranging from a severe handicap to a cosmetic fault. This paper suggests a possible way of objectivating the symptoms, which are often only subjective or only indirectly correlated with the basic illness. Such (psychosocial) stress increases with increasing age, or rather with increasing self-reflection. In these patients, one finds, among other symptoms, reduced capacity for exertion, inhibition of autonomous tendencies, poor estimation of their appearance, subjective feelings of stigma, exaggerated suggestibility, orientation towards failure, fear, and specific shame reactions. The formation of these reactions has a concrete effect on all essential aspects of the patient's way of life. It is recommended that the term "cosmetic indication" be no longer used in diagnosis, and that specific psychotherapeutic measures, as well as operative correction, should as a rule be carried out.