[Psychodynamics of Bechterew's disease]

Following earlier psychoanalytical articles on polyarthritic diseases without rheumatism factor, this investigation reports on patients with morbus Bechterew. The psychoanalytically expanded anamneses showed a distinct predominance of hysterical and depressive structures. With their friendly, open nature these patients appear cooperative and tension-free. They have problems when aggressive confrontations occur, especially with good acquaintances, from whom they expect recognition and friendly or loving attention. They try to earn these through a strong readiness to help, which often reaches a point of exhaustion. The causing situations appear especially characteristic: Before the disease started, most patients were able to sow their wild oats in all directions for a pretty long time. The disease breaks out when this lax style of living is given up, for the partner's sake, in a marriage or other firm kind of relationship. In their new life situation the patients cannot fully live their aggressive as well as their sexual needs in the accustomed way. A heightened muscular tension, as the physical correlate of this affective restraint, is postulated, which, as one of the factors, plays a role in the origin of morbus Bechterew.