The role of preventive psychiatry in physical disability

Many patients suffering from injury or chronic illness appear to experience greater disability than one would expect from the nature of their physical lesion. Although one suspects that emotional problems are complicating their somatic illness, the defence of counterdependence masks an overt show of emotional disturbance. Furthermore, their personality structure places them at risk for developing chronic psychological invalidism, the prevention of which requires (1) an early diagnostic recognition of patients characterologically at risk for psychological complications, and (2) behavior of caretakers designed to foster the drive of each patient toward independence and to minimize the regression towards psychological invalidism.