Psychoses associated with essential hypertension

Conclusions

• 1. The psychotic manifestations of hypertensives are variable.

• 2. A slow heavy gait, a markedly restrained-looking facies, exhibitionism and a grossly defective sexual life are present in these cases.

• 3. Strongly suppressed anxiety, hostility, passivity, and feelings of guilt are evident.

• 4. These cases fall into two groups:

  Group 1: Where the hypertension subsides after several months as a result of a period of excitement wherein some anxiety and hostility are given off and the patient later develops defensive measures to separate himself from extraneous influences which induce anxiety or hostility.

  Group 2: Where the hypertension does not subside. In these patients there are no distinct periods of excitement, and the hostility or anxiety continues to be markedly suppressed.

• 5. The conflicts in the hypertensive psychotic have a narcissistic basis.

• 6. These patients seem to have a diminished faculty for thought or ideational elaboration and, failing to find sufficient outlet in this way, probably seek somatic expression through the cardiovascular system.