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Minerva Psichiatrica 2002 September;43(3):151-60

language: Italian

Psychological and psychopathological evaluation using the Rorschach test in a sample group with somatisation disorders

De Bertolini C., Andreeto U.


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Background. 16% of the requests for consultations received by our Medical Psychology Centre are submitted by colleagues faced with physical symptoms in patients that cannot be explained by a general medical condition. In order to evaluate the personality traits of these patients more accurately, we have used both clinical interviews and Rorschach testing. To give a clearer focus to the research, only those patients with symptoms attributable to ''Somatisa-tion disorders'', as classified by DSM IV, were included in the study.
Methods. After evaluating the patient's psychological and psychopathological status during the first visit, as requested by the colleague in the request for a consultation, the Rorschach test was completed at the next meeting. None of the 16 hospitalised female patients we met refused the interview or the test, although they all expressed perplexity regarding the possible psychological origin of their disorders.
Results. The analysis of the Rorschach protocols revealed a number of common denominators. Patients with somatisation disorders showed an almost complete lack of G answers involving combination and movement. The disappearance of these two factors cab be seen as an attempt to remove disturbing images and the ''struggle'' against the latent content of the figures. The effort not to ''reveal anything'' (belle indifference) was obvious from the sudden fall in G+%, F+% and the Ban answers. With reference to the emotional register, a significant increase was noted in the colour answers resulting in an accentuated extratensive ET1 (Erlebnistypus). The abundant production of colour answers often expresses the ''dramatisation'', namely the staging of representations and feelings through scenarios that enable their elaboration with varying degrees of success. The overuse of colours by these patients reveals sensorial hypersensitivity used to fight against anguish caused by the emergence of unconscious images, often linked to the absence of a good relationship with the maternal figure. In terms of social adaptagion, there is a marked decrease in answers with human content, revealing the difficulty of interaction with other persons, demonstrating their own emotional experience and sharing their own difficulties.
Conclusions. The complex approach to patient with somatisation disorders highlights the need and opportunity for collaboration between different professional fields in order to define the most suitable therapeutic protocol that does not lead, as often happens, to expulsive actions by the health authorities and the constant search for ''somatic solutions'' by the patients.

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