Objectives To examine the role of psychological defense mechanisms (PDM) and level of subjective control (LSC) in the development of affective disorders in patients with rheumatoid arthritis (RA).
Methods We observed 28 patients with RA. The average age was 55, 59±8, 76 years and the average duration was – 7, 2±4,3years. The questionnaire “level of subjective control” (LSC) (Bazhin E. F., et al. 1993) was used in the study. Psychological defense mechanisms were studied according to the “index of lifestyle” inventory (IL) (E. B. Klubov et al., 1995). The study of affective disorders was conducted by the “neuroticism and psychopatization” psychological test (L. L. Dmitrieva, 1990).
Results In women, a high intensity of PDM in the type of “Reactive formation” was seen. And in men, a higher tension in PDM in the type of “Displacement” and “Intellectualization” (p<0.01) was noted. RA patients with the third stage of activity had lowest indices related directly to defense “Denial” (p<0.05). Asthenia, depression, anxiety and hypochondria are directly correlated with the parameters of PDM “Reactive formations” (H). The level of asthenia and anxiety were directly correlated with intensity of “Regression” defense mechanism (r=0,316 and r=0,365; p=0.010 and p=0.003). The level of asthenia and depression were directly correlated with the defense “Projection” (r=0,399 and r=0,343; p=0.001 and p=0.005).
Patients with RA were mostly characterized by external locus of control in common sphere (3,81+1,387), failures (3,51+0,64), family relations (4,18+0,55), industrial relations (2,74+0,98), health (4,66+1,94). The general internal locus of control in RA patients was significantly decreased (p=0.006) along with increasing stage of the disease. Significant negative correlations were established between the levels of asthenia, anxiety and hypochondria and internal locus of control (p=-0, 45; p=-0, 52; p=-0, 40, respectively, when r=0,005); and between level of anxiety and internality of failures (p=-0, 42, p=0.05).
Conclusions The obtained data indicate the passiveness of RA patients fighting with the disease, and failure to appreciate the connection between their actions and important events of their lives; hence in this background, a choice more towards non-adaptive psychological defense mechanisms is made which in turn exacerbates the neurotic reactions in RA patients.
Disclosure of Interest None declared
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