PSYCHOLOGICAL STATUS OF ESRD PATIENTS ON HEMODIALYSIS

In patients with chronic renal failure due to a prolonged state of cor poreal imperilment, an establishment of heightened psychic tension can be noted. This entails an associative relationship between the corpor eal and the emotional. Hemodialysis, as the essential modality of trea tment, makes up for the loss of the bodily function, but at the same t ime reminds the recipient of the reduction of life activity, thereby a dding to the newly formed specific psychic status. Depending on the pr emorbid psychic structure of the patient, already existent conscious a nd subconscious personal conflicts are provoked and triggered, and thi s leads to the hypertrophy of the previously existing character traits . The essential psychological content in the clinical status of the pa tient is anxiety as a response to the biological peril. Pronounced anx iety endangers adaptation and activates the development of primitive d efense mechanisms such as denial, displacement, regression, affective isolation, intellectualization, projection, and excessive religious at titudes. Depression, mainly of symptomatic origin, appears to be rathe r common in such patients. Suicide is the main complication, and most frequently presents itself in the form of ''passive suicide.''