Forty-three patients on chronic hemodialysis were observed in a prospective study on the effects of a number of personality factors on noncompliance with a medical regimen (diet). It was found that low frustration tolerance and gains (primary and secondary) from the sick role were the most frequent causes for noncompliance, and these differentiated significantly between compliers and noncompliers, while “acting out” was frequent in both groups though more severe in the noncompliers. Other factors such as denial of sick role and suicidal behavior were also found, although more rarely.
The importance of identifying the specific factors in each individual patient was stressed as it would dictate the strategy of the psychotherapeutic intervention.
Although only dialysis patients were included in this study, it was suggested that the personality factors described can be identified in other patients and other medical setups as well.