Psychosocial factors and incidence of peritonitis

It has been suggested that psychosocial (PS) factors may influence morbidity and mortality in chronically ill patients. However, investigators have not examined how PS factors affect specific medical problems in chronic peritoneal dialysis (CPD) patients. Sixty-eight patients maintained on CPD therapy were studied. PS testing included a self-rating form of patient-assessed quality of life (PaQOL), depression [Beck's Depression Inventory (BDI)], anxiety [Patient Rated Anxiety Scale (PRAS)], and assessment of physical symptoms (KDS-II). Peritonitis rates six months prior to PS assessment and six months after assessment were tabulated. The data show that during the study period patients with more than one episode of peritonitis compared to those with no episodes of peritonitis had: (1) significantly higher anxiety and physical symptom scores; (2) significantly lower PaQOL; and (3) higher depression scores, which did not reach statistical significance (p < 0.06). Whether higher peritonitis rates result in worse PS symptoms, or whether poor PS symptoms cause higher peritonitis rates needs to be determined with further investigations.