title: The psychological impact of ambulatory peritoneal dialysis on adults and children.
abstract: The most common medical complication causing patient and spouse reaction remains peritonitis. Psychological difficulties include different levels of problems with body image distortion and major role reversal issues with resulting significant marital discord, especially in our diabetic patients. Contrary to patients on maintenance hemodialysis and IPD, no patients were noted to become pathologically depressed although adjustment problems manifested as depression were seen. The increasing role of technology in treatment means that greater attention should be paid to how patients relate psychologically to the application of what can seem to be overpowering or even fearsome technical means. Appropriate evaluation and selection of candidates for CAPD can enable these chronically ill persons to better control and adapt to the critically necessary procedure of dialysis. In the words of a 55-year-old gentleman on CAPD for three years: "It is unbelievable how much freer and fitter I feel since being on CAPD. I have had several holidays and can drive 200 miles on my own without difficulty. The main advantage to me is that CAPD has restored my independence. I feel well enough to enjoy life--the best criterion for judging any treatment."
authors.affiliation: Department of Psychiatry, Cleveland Clinic Foundation, Ohio.
authors.forename: L
authors.initials: L
authors.lastname: Gonsalves-Ebrahim
authors.forename: M
authors.initials: M
authors.lastname: Kotz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001828:Body Image; D005190:Family; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology*; D011936:Reality Testing; D012803:Sick Role; D012944:Social Support