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Published on: October 2, 2020
Psychiatric comorbidity in patients undergoing hemodialysis
Ekram Goyal1, Suprakash Chaudhury1, D Saldanha1
1Department of Psychiatry, Dr. D.Y. Patil Medical College, Pune, Maharashtra, India.
Insights
Patients on hemodialysis experience significant stress, with nearly half developing psychiatric conditions like depression and anxiety. Early intervention is crucial for managing mental health in these patients.
Area of Science:
- Nephrology
- Psychiatry
- Clinical Medicine
Background:
- Hemodialysis patients face substantial physical and mental stress.
- Existing research suggests a higher incidence of psychiatric morbidity in this population.
Purpose of the Study:
- To determine the prevalence of psychiatric comorbidity among patients undergoing hemodialysis.
- To identify specific psychiatric disorders common in hemodialysis patients.
Main Methods:
- A cohort of 49 chronic kidney disease patients on hemodialysis provided informed consent.
- Psychiatric assessments were conducted post-dialysis using standardized tools like the Schedule for Clinical Assessment in Neuropsychiatry and Hamilton rating scale for depression.
- Institutional Ethics Committee approval was secured prior to the study.
Main Results:
- 45% of the 49 patients (aged 15-64) exhibited psychiatric comorbidity.
- Depression was the most prevalent diagnosis (26%), followed by adjustment disorder (12.2%).
- Other identified conditions included generalized anxiety disorder, mixed anxiety and depression, and alcohol use disorders.
Conclusions:
- Patients initiating hemodialysis are at increased risk for psychiatric illnesses.
- The chronic, debilitating nature of kidney disease requiring dialysis significantly impacts lifestyle, occupation, and finances, contributing to mental health issues.
- Mood disorders appear more common than other psychiatric conditions in this patient group.
Background:
Patients undergoing hemodialysis are under considerable physical and mental stress. Few studies indicate an increase of psychiatric morbidity in them.
Aim:
The aim is to study the prevalence of psychiatric comorbidity in patients undergoing hemodialysis.
Materials And Methods:
A total of 49 consecutive patients of chronic kidney disease undergoing hemodialysis were included in the study with their consent. The Institute Ethics Committee clearance was obtained before the start of the study. The psychiatric interview was conducted only after the dialysis procedure was over. Patients were assessed using the Schedule for Clinical Assessment in Neuropsychiatry and Hamilton rating scale for depression.
Results:
A total of 49 patients in the age range of 15-64 years were included in the study. Majority of the sample was males (75.5%). Out of the patients enrolled in the study group, 45% had psychiatric comorbidity which included depression (26%), adjustment disorder (12.2%), generalized anxiety disorder (2%), mixed anxiety and depression (2%), and mental and behavioral disorders due to harmful use of alcohol (2%) indicating that patients undergoing hemodialysis is more likely to have mood disorder than other psychiatric disorders.
Conclusion:
Patients with recent-onset dialysis are more prone to psychiatric illnesses as it has a chronic debilitating course with poor outcome leading to major lifestyle changes with occupational disturbance and consequent financial implication.
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