[Psychiatric and psychosocial aspects of chronic renal failure]

Primary treatment modalities of chronic renal failure (CRF) are dialysis and renal transplantation. According to 1997 data there were 10,000 hemodialysis and 1893 continuous ambulatory peritoneal dialysis (CAPD) patients in Turkey. On a yearly basis 360 renal transplantation procedures take place. In deciding for one of the treatment modalities, medical criteria are of partial importance. On the other hand, in terms of psychosocial adjustment and functioning and quality of life, even the expert clinicians emphasize that is very difficult to predict which treatment modality is best for the patient. While some researchers report that psychiatric morbidity and disability of CRF are high and there is no difference between the chosen treatment modalities, most of them report that transplantation is more advantageous than dialysis, and quality of life is better in transplant patients. On the other hand, some researchers claim that psychological adjustment varies during the treatment of CRF and psychiatric symptoms decrease with time. In this paper, psychiatric and social problems in CRF and the effect of these problems on quality of life are reviewed. According to our literature review covering the past 30 years, there have been many researchers for the CRF patients' psychosocial difficulties. Also most of this research work compare treatment strategies with respect to psychiatric morbidity and quality of life.