Affective and personal determinants of formation of an attitude towards the disease in patients with type 1 diabetes mellitus

A hundred and twenty-six outpatients (41 males and 75 females) with type 1 diabetes mellitus were examined to study the affective and personal determinants of their attitude towards the disease at the Saint Petersburg City Diabetes Center within the framework of cooperation of the V. M. Bekhterev Psychoneurological Research Institute and the Academician I. P. Pavlov Saint Petersburg State Medical University. The examinees' mean age was 31.8±10.1 years. The mean duration of the disease was 17.1±8.3 years. Most patients were found to have symptoms of late diabetic complications. The patients' attitude towards the disease and their affective and personal characteristics were examined, by using a test for the psychological diagnosis of the types of an attitude towards the disease, scales for the rapid psychological diagnosis of neurotization, and the questionnaire "Copying ways". Analysis of the results led to the following conclusions: the probability of hypemosognostic reactions in patients with type 1 diabetes mellitus is relatively independent of the objectively assessed severity of the disease; the affective and personality characteristics associated with hypemeurotization considerably increase the risk of the hypemosognostic type of the internal picture of the disease, which is largely mediated by a tendency for avoidance behavior and by the lack of stress-coping behavioral skills, mainly problem solution-planning and self-regulation skills. Psychological correction aimed at enhancing the emotional stability of a personality and developing stress-coping skills seems to improve the adaptation of patients with type 1 diabetes mellitus to their disease.

1. Вассерман Л. И., Вукс А. Я.., Иовлев Б. В., Карпова Э. Б. Методика для психологической диагностики типов отношения к болезни: Метод. рекомендации. - Л., 1987; 2001.

2. Вассерман Л. И., Вукс А. Я., Иовлев Б. В., Карпова Э. Б. // Психологическая диагностика отношения к болезни при нервно-психической и соматической патологии. - Л., 1990. - С. 8-16.

3. Вассерман Л. И., Трифонова Е. А. // Вестн. клин. психол. -2004. - Том 2, № 1. - С. 72-83.

4. Дробижев М. Ю. Нозогении (психогенные реакции) при соматических заболеваниях: Дис.... д-ра мед. наук. - М., 2000.

5. Иовлев Б. В., Карпова Э. Б. Психология отношений. Концепция В. Н. Мясищева и медицинская психология. - СПб., 1999.

6. Иовлев Б. В., Карпова Э. Б., Вукс А. Я. Шкала для психологической экспресс-диагностики уровня невротизации (УН): Пособие для врачей и психологов. - СПб., 1999.

7. Лурия Р. А. Внутренняя картина болезни и ятрогенные заболевания. - М., 1977.

8. Новик А. А., Попова Т. И. Исследование качества жизни в медицине. - М., 2004.

9. Резникова Т. Н. Внутренняя картина болезни: структурно-функциональный анализ и клинико-психологические соотношения: Автореф. дис. ... д-ра мед. наук. - СПб., 1998.

10. Brown S. // Res. Nurs Hlth. - 1992. - Vol. 15, N 6. - P. 409-419.

11. Cohen M., Tripp-Reimer Т., Smith C. et al. // Soc. Sci. Med. -1994. - Vol. 38, N 1. - P. 59-66

12. Folkman S., Lazarus R. Manual for the Ways of Coping Questionnaire. Palo Alto, 1988.

13. Glasgow R., Ruggiero L., Eakin E. et al. // Diabetes Care. - 1997. - Vol. 20, N 4. - P. 562-567.

14. Lennon G., Taylor K, Debney L., Bailey C. // Diabet. Med. - 1990. - Vol. 7, N 9. - P. 825-832.