Neurobiological model and quality of life in discovering personality of the uremic patient.

ABSTRACT

The Short Form-36 Health Survey (SF-36) questionnaire is designed to measure the patient's functional capacity and well-being. It was created to reach a compromise between lengthy investigation methods and one dimensional, overly simple tools for measuring quality of life (QoL). In 1987, the psychiatrist Robert Cloninger proposed a psycho-biological model hinged upon three principal and independent dimensions of the human personality novelty seeking (NS), harm avoidance (HA) and reward dependence (RD), linked with dopaminergic, serotoninergic and noradrenergic activity, respectively. According to Cloninger, each dimension is the expression of the integration of a hereditary condition, characterized by biologic substrates, in response to specific environmental stimuli. We furthermore searched for any interference between the SF-36 scores and plasmatic dopamine, serotonin and noradrenaline concentrations, in an attempt to identify eventual correlations between the condition of the patients, their subjective QoL evaluation and neurohormonal plasmatic equilibrium. We compared results obtained from healthy subjects with populations of patients in different periods of their clinical existence patients on hemodialysis; with a functioning transplantation; with renal graft function loss; returning to dialysis after graft loss and two years after restarting hemodialysis.