Purpose: Psychology defines cumulative trauma as a mental structure predisposed to suffering that can switch between somatic and psychological. Psychosomatic risk predisposes some patients to balance in pathology, between depressions requiring medication and serious somatic diseases. This paper presents a 68-year-old patient with psychiatric admissions for an organically altered personality, in which prevails a relationship sensitivity, major depression and sensitivity to rejection. In the somatic area, he presents a skin tumor with unpredictable and unknown evolution in the right jaw, BPOC, HTA, left ventricular pertrochanterial MI fracture (migration of the nail implant, atrial fibrillation, HVS), nodular opacities, homogeneous, same intensity as ribs, located in 1/2 inferior lung, with a tendency to confluence. Methods: hospitalization, psychiatric assessment under antidepressant and antipsychotic treatment with HAM, PANSS, GAFS, life quality scales, lung Rx, basal Rx, ECG, EEG, cerebral MRI, counseling, social assistance. Results: The view of cumulative trauma explains the psychotic depression in which the externalization of persecutory projections predominates, while a neoplastic pathology of both skin and lung develops in the somatic area. The multiple, painful somatic experiences which are hardly responsive to analgesics (including opioids) amplify the signs of cerebral organicity (supported by EEG, MRI and psychological evaluation), in which the nature of rejection, as well as activation of the paranoid nucleus and the feelings of hatred and revenge are externalized in a pervasive way. Conclusions: The psychogenic coefficient in neoplastic pathology is represented at the level of primitive defense mechanisms, the personality structure being dominated by the unconscious aggressiveness turned towards himself.
