1998 Volume 31 Issue 10 Pages 1323-1330
Restriction of daily fluid intake could be important in preventing cardiovascular complications which are a major cause of death in chronic hemodialysis patients. However, a significant number of hemodialysis patients fail to control fluid intake. Therefore, we studied the relationship of personality and fluid restriction in hemodialysis patients using the Minnesota Multiphasic Personality Inventory (MMPI).
Object and method: From a list of 398 patients undergoing hemodialysis therapy at Seishokai clinics, we selected two groups. The first group (poor control group) consisted of 51 patients (male: 34, female: 17) whose weight increase between hemodialysis therapy (48 hours) was more than 5% dry weight. The second group (good control group) consisted of 33 persons (male: 16, female: 17) whose weight gain between hemodialysis therapy (48 hours) was less than 3% dry weight.
We conducted the MMPI (New Japanese version, Sankyobo, Kyoto) on these hemodialysis patients, totaling the mean scores of the respective scales between the two groups by male and female, and comparison was thus made. Comparison with 1, 022 normal adults (male: 500, female: 522) was also performed when the MMPI was standardized in Japan.
Result: We could observe a trend wherein the poor control group showed higher scores on scales for Hs (hypochondriasis), D (depression), Hy (hysteria) and Pd (psychopathic deviation) compared with those in the good control group, but there were no significant differences.
Compared with the normal adults, both the poor control group and good control group showed significantly high scores at measurements of L (lie), Hs, D, Hy and Es (ego strength).
Assessment: High scores for Hs, D and Hy in both the poor control group and good control group observed in this study are suggestive of depressive situation and somatic overconcern or anxiety in hemodialysis patients. Elevation of these three scales has been called the neurotic triad. So, dialysis patients have a tendency toward neurotic symptoms with depression and anxiety. Although no significant differences were observed, this tendency was stronger in the poor control group than in the good control group. A low value for Es in both groups indicates the fragility of the ego and suggests the frailty of hemodialysis patients.
