[Psychological respond to the disease and treatment devotion]

To evaluate the degree of adherence to treatment in comparison with the psychological reactions to the disease in patients with chronic diseases of the digestive system.

We examined 106 patients with chronic diseases of the upper gastrointestinal tract. Psychological reactions to the disease were studied using personality questionnaires of the Bekhterev Institute (the St. Petersburg V.M. Bekhterev Psychoneurological Research Institute), adherence to treatment--using a specially designed questionnaire. 52 patients were polled again at 6 months after discharge from hospital.

High adherence was diagnosed in 47.2%, satisfactory--in 44.3%, and lower--in 8.5% of cases. Hypernosognosia reaction to the disease in patients with low levels of compliance were more frequent than in patients with a high level of compliance (77.8 and 12.0%, respectively). The obtained result suggests that excessive emotional tension, high levels of anxiety and the stress response prevent adequate inclusion of patients in the treatment process. A similar situation persists in 6 months after discharge from hospital. This is confirmed by clinical observations indicating that this type of reaction to a disease peculiar to the mature person who knows how to extract the experience of adverse life situations.

The results confirm the absence of an adequate level of adherence to treatment in patients with chronic diseases of the digestive system. In particular this applies to patients with inadequate emotional response to diseases. In this regard, in terms of improving adherence increases the importance of timely diagnosis of anxiety and depression with subsequent correction of the violations.