Personality Correlates of Survival in a Long-Term Hemodialysis Program

The Problem of Fatigue in Dialysis Patients

“…Fatigue is also often an accompaniment of depression, and depression has been widely ascribed to dialysis patients [2,3,9]. A comparison of depression scores and fatigue rating showed that those reporting high fatigue in the morning tended to have the highest depression scores even when questions related to fatigue were deleted from the psychological test.…”

The Psychological Aspects of Chronic Hemodialysis*

“…Most authors related depression to stresses induced by the mechanical difficulties and to the stresses of living with dialysis as a requisite for life maintenance. Glassman (11), using the Shipman Anxiety Depression Scale, and Gentry and Davis (10), using the Zung Self-Rating Depression Scale, found a discrepancy between the low level of depression and anxiety reported by the patients and their appearance as lethargic, depressed, and suffering from generalized pruritis.…”

“…Authors reported repeatedly (I, 8,11,16,18,24,28,32,34) that the major adaptational problem in hemodialysis lies in the area of emotional dependency. Dependence on the dialysis machine for survival is a reality, and it has been suggested that psychological dependency needs expand to the point where staff are unable to gratify them.…”

“…Abram (3), writing on suicidal behaviour in chronic dialysis patients, suggested that the high incidence of suicide is related to the emotional consequences -the difficulty in accepting dependency generated by passivity and inactivity. Depression has been noted by many authors (1,2,8,10,11,17,18,24,28,(32)(33)(34) to be a major problem. Reichman and Levy (28) found that all their twenty-five patients were significantly depressed before acceptance into the dialysis program.…”

“…In 1965 Shea et al (32) concluded that nine patients followed over two and a half years manifested significant adverse psychological reactions while under the dialysis program and they exhibited poor acceptance and adjustment. Glassman (11) in 1970 attributed the poor treatment 'results in these 'Manuscript received November 1974. 'Department of Psychiatry, Ottawa Civic Hospital, Ottawa, Ontario.…”