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Psychosomatic Medicine 34:333-344 (1972)
© 1972 American Psychosomatic Society

Personality Factors in Chronic Hemodialysis Patients Causing Noncompliance With Medical Regimen

A. KAPLAN DE-NOUR MD1 and J. W. CZACZKES PhD, MD1

1 Department of Psychiatry and the Nephrological Service, Hadassah University Hospital and Medical School, Jerusalem, Israel

Address for reprint requests: A. Kaplan De-Nour, MD, Department of Psychiatry, Hadassah University Hospital, PO Box 499, Jerusalem, Israel.

Forty-three patients on chronic hemodialysis were observed in a prospective study on the effects of a number of personality factors on noncompliance with a medical regimen (diet). It was found that low frustration tolerance and gains (primary and secondary) from the sick role were the most frequent causes for noncompliance, and these differentiated significantly between compliers and noncompliers, while "acting out" was frequent in both groups though more severe in the noncompliers. Other factors such as denial of sick role and suicidal behavior were also found, although more rarely.

The importance of identifying the specific factors in each individual patient was stressed as it would dictate the strategy of the psychotherapeutic intervention.

Although only dialysis patients were included in this study, it was suggested that the personality factors described can be identified in other patients and other medical setups as well.

Submitted on July 22, 1971
Revised on January 5, 1971




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