Psychological Factors and Reticuloendothelial Disease

Abstract

Summary Observations are reported on 33 children and adolescents below age 20 with leukemia. The usual diagnostic categories, symptoms, and age and sex distribution occurred in this group. The frequency of various types of loss, separation, or threats of separation for the individual child is described. These losses included advent of a sibling rival, change of home, change of school, and loss or threat of loss of a significant person such as the father or maternal grandparents through death or illness. One or more of these kinds of losses occurred for 31 of the 33 patients. Half of such separations or losses during the 2-year prodromal period occurred during 6 months prior to the apparent onset of the disease. In addition, 27 of the 33 mothers were depressed and/or anxious for weeks or months before evident symptoms developed in the child. From the data observed in these patients, we consider that separation from a significant object with ensuing depression may be one of the conditions determining manifest development of leukemia in children as our previous studies suggested in adults. The findings in the individual patient and his or her mother are discussed in the perspective of the mother-child unit, meaning a mutual psychophysiologic unit in prenatal as well as postnatal development of the child with the mother. From these considerations, formulations are proposed for comprehending some of the multiple conditions determining the occurrence of leukemia in an individual child.