Background The disturbances of the system of personality’s attitudes and psychological specificity of the disease perception reflect in the patient’s behaviour that plays an important role in therapy and rehabilitation.

Objectives The aim of present study was to investigate some elements of internal image of illness, including some aspects of psychological status in patients with fibromyalgia (FM) and systemic lupus erythematosus (SLE).

Methods Using a battery of psychological tests, we determined the level of neurotic disturbances, the level of subjective control (Health Locus of Control), the type of attitude towards illness (TOBOL) and the intensity of basic mechanisms of psychological defence (Life Style Index) in 32 patients with FM and 55 patients with SLE.

Results The results of our study are the evidence of considerable expressed anxiety and asthenia, low scores on general internality and internality concerning health and illness scales in FM and SSc patients.

The structure of internal image of illness represented by sensitive and ergopathic types in FM patients, and sensitive, ergopathic, hypochondriac and neurasthenic types of attitudes towards illness ? in SLE patients. We revealed a narrow spectrum of intense psychological defence: ?jet formation?, ?projection?, and ?regression? in FM patients, and ?jet formation?, ?projection?, and ?intellectualisation? ? in SLE patients.

A reliable differences were founded between FM and SLE patients: depression was more expressed in SLE than in FM patients (p < 0,05), the index of internality concerning health and illness was higher in FM than in SLE patients (p < 0,05). Besides, the anxious and sensitive types of reacting towards illness are more frequent in FM than in SLE patients (p < 0,05).

Conclusion The data we obtained indicate the development of substantial neurotic disturbances in FM and SLE patients. The decrease of subjective control?s level, especially in SLE patients are the evidence that these patients may be particularly likely to develop the belief that their disease is beyond their effective control. These patients, therefore, perceive that they will not be able to reduce substantially the pain, disabilities, or other sequel of the disease. It may lead to maladaptive behaviour such as nonadherence to treatment regimens, reliance upon ?quack? cures, and excessive use of medicines.

The mixed type of attitudes towards illness that we diagnosed in FM and especially in SLE patients indicate the discrepant nature of the structure of personal attitudes related to the disease. An essential pressure and prevalence of founded types of psychological defence indicate to narrowing of adaptive abilities of FM and SLE patients.

The results of research we carried out may be useful to correct nonadaptive attitudes of patients towards the disease in good time, to use psychological interventions in order to increase the efficiency of the therapy and to optimise rehabilitation.