Hemodialysis 환자 가족의 정신신체의학적 반응

Psychosomatic Ractions in the Family Members of Hemodialysis Patients

Twenty two family members of prolonged hemodialysis patients were interviewed to study the psychosom atic reactions to hemodialysis procedures. And a scale for self-assessment of anxiety and depression was used to compare with the ordinary neurotic depressives. The results showed that the family members had suffered from a characteristic reactive depression which resembled neurotic depression. The symptoms were characterized by far less som atization, weeping spells, feeling that life is not worth living, loss of enjoyment and loss of appetite and libido. The etiological factors seemed to be, as situational ones, stress from financial problems, physically painful experiences and possible impending death and future uncertainty of family life. Inner conflicts as ambivalence and guilt feeling centered around donation of kidney for transplantation, the decision of stopping treatment, and hostility and resentment reactive to longterm dependency of patients and their neurotic or even psychotic behaviors, played, etiological roles as well. This reactive depression was more severe when the family members were wives, older in age, and sensitive, hot-tempered and obsessive in i personality, but less severe when they were less educated or when they, were Christian and extrovert and active in personality. These results suggest that there are some psychodynam ic correlations between the characteristic symptoms of the reactive depression, especially less somatization, and the clear and open situational factors in etiology.