Abstract
Background and Aims
Procedure of haemodialysis (HD) treatment is associated with an impaired quality of life in chronic kidney disease patients. It is due to changes in family, social and professional relationships. These changes can also lead to mental health problems. The purpose of our study is to determine the prevalence of depressive and anxiety disorders in hemodialysis patients.
Method
Fifty chronic hemodialysis patients were enrolled in our cross-sectional study during four months (September -October- November- December 2019). The HADS (Hospital Anxiety and Depression Scale) survey was used to assess depressive and anxiolytic disorder in our hemodialysis population. Were excluded patients aged less than 18 yearsold as well as kidney transplant patients and psychiatric patients.
Results
The mean age of our patients was 49.5 range (24-79).The sex ratio was 1.27. The prevalence of anxiety syndrome was 40% with a female predominance of 54.5% versus 54,5%. Depressive syndrome was noted in 48% of our patients with a male predominance of 58.3% versus 41,7%.
48% of our HD patients have shown depression in various degrees. It was about mild depression of 20,8% of pts, moderate depression of 41,6% of pts and severe depression of 37,5% of pts. Somatic symptoms of depression in our population were respectively noted in 52,8% of loss of energy, 57,5% fatigue, 63,4% sleep disturbances, and 38,5% changes in appetite. The most common psychological symptoms were: pessimism (79,1%), loss of interest in appearance (41,6%), psychomotor retardation (75%).
On the other hand, 37, 5% of patients felt cheerful and 16,6% still enjoy doing some activities. For patients with anxiety syndrom, we noted: concentration disturbance (45,4%), palpitations (50%), abdominal pain (59,09%) and headache (81,8%).
With regard to psychological symptoms, the most emphasized were: sudden feelings of panic (54,5%), worrying thoughts (72,7%),77,2% are feeling restless and 59,09% are feeling wound up.
On the other hand, 68,1% feel relaxed especially after the hemodialysis session. It seems that gender, marital status and HD duration did not influence significantly in occurrence of depression with respectively (p=0,08, p=0.1 and p= 0.08). Older patients were significantly more depressed in compared to younger patients (p= 0.003). Unemployed patients were significantly more depressed in relation to employed patients(p=0.01). Finally, as the educational level of patients increased, level of depression significantly decreased (p=0,04).
Conclusion
Depression is the most frequent psychological complication of hemodialysis (HD) patients. Our results showed a high prevalence of depressive symptoms among the study group. The exact prevalence of depression in dialysis patients is unclear because of different criteria utilized for diagnosis of depression. A close collaboration between nephrologists and psychiatrists is needed to ensure a better quality of life in HD patients.
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