Back to Browse Journals » Patient Preference and Adherence » Volume 4

Ego mechanisms of defense are associated with patients’ preference of treatment modality independent of psychological distress in end-stage renal disease

Authors Thomas Hyphantis, Spiros Katsoudas, Sonia Voudiclari

Published Date February 2010 Volume 2010:4 Pages 25—32

DOI http://dx.doi.org/10.2147/PPA.S7796

Published 18 February 2010

Thomas Hyphantis1, Spiros Katsoudas2, Sonia Voudiclari3

1Associate Professor of Psychiatry, Department of Psychiatry, Medical School, University of Ioannina, Ioannina, Greece; 2Nephrologist, Renal Clinic, Hippocration General Hospital, Athens, Greece; 3Department of Nephrology, University of Athens, Greece

Abstract: Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD). The nephrology community suggests that patient preference should be the prime determinant of modality choice. We aimed to test whether ego mechanisms of defense are associated with patients’ treatment modality preferences, independent of psychological distress. In 58 eligible ESRD patients who had themselves chosen their treatment modality, we administered the Symptom Distress Checklist-90-R and the Defense Style Questionnaire. Thirtyseven patients (53.4%) had chosen hemodialysis and 21 (46.6%) peritoneal dialysis. Patients who preferred peritoneal dialysis were younger (odds ratio [OR], 0.89; 95% confidence interval [CI]: 0.804–0.988), had received more education (OR, 8.84; 95% CI: 1.301–60.161), and were twice as likely to adopt an adaptive defense style as compared to patients who preferred hemodialysis (57.1% vs 27.0%, respectively; P < 0.033). On the contrary, the latter were more likely to adopt an image-distorting defense style (35.1% vs 14.3%; P = 0.038) and passive–aggressive defenses (OR, 0.73: 95% CI: 0.504–1.006). These results were independent of psychological distress. Our findings indicate that the patient’s personality should be taken into account, if we are to better define which modalities are best suited to which patients. Also, physicians should bear in mind passive–aggressive behaviors that warrant attention and intervention in patients who preferred hemodialysis.

Keywords: end-stage renal disease, hemodialysis, peritoneal dialysis, ego mechanisms of defense, DSQ, psychopathology

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Other articles by this author:

Narcissistic rage: The Achilles’ heel of the patient with chronic physical illness

Thomas Hyphantis, Augustina Almyroudi, Vassiliki Paika, et al

Patient Preference and Adherence 2009, 3:239-250

Published Date: 9 August 2009

Readers of this article also read:

Wine consumers’ environmental knowledge and attitudes: Influence on willingness to purchase

Nelson Barber, Christopher Taylor, Sandy Strick

International Journal of Wine Research 2009, 1:59-72

Published Date: 9 February 2009

Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors

Eduardo Pimenta, Suzanne Oparil

Vascular Health and Risk Management 2009, 5:453-463

Published Date: 19 May 2009

Health literacy and health seeking behavior among older men in a middle-income nation

Paul A Bourne, Chloe Morris, Christopher AD Charles, et al

Patient Related Outcome Measures 2010, 1:39-49

Published Date: 26 May 2010

Comparison of two treatments for coxarthrosis: local hyperthermia versus radio electric asymmetrical brain stimulation

Castagna A, Rinaldi S, Fontani V, Mannu P, Lotti Margotti M

Clinical Interventions in Aging 2011, 6:201-206

Published Date: 25 July 2011

Preparation, characterization, and efficient transfection of cationic liposomes and nanomagnetic cationic liposomes

Samadikhah HR, Majidi A, Nikkhah M, Hosseinkhani S,

International Journal of Nanomedicine 2011, 6:2275-2283

Published Date: 12 October 2011

Chitosan–Pluronic nanoparticles as oral delivery of anticancer gemcitabine: preparation and in vitro study

Hosseinzadeh H, Atyabi F, Dinarvand R, Ostad SN

International Journal of Nanomedicine 2012, 7:1851-1863

Published Date: 11 April 2012

The skin landscape in diabetes mellitus. Focus on dermocosmetic management

Piérard GE, Seité S, Hermanns-Lê T, Delvenne P, Scheen A, Piérard-Franchimont C

Clinical, Cosmetic and Investigational Dermatology 2013, 6:127-135

Published Date: 15 May 2013