Quality of life and psychiatric symptom distribution in chronic dialysis patients

Objective: End stage kidney failure cause many psychosocial problems and decrease quality of life (QoL). Our aim in this study was to determine QoL and psychiatric symptom distribution in chronic dialysis patients. Methods: Fifty-four chronic hemodialysis (HD) and 13 continuous ambulatory peritoneal dialysis (CAPD) patients (total 67 patients) who have been followed up by our nephrology unit have been included in this study. The tests applied in all patients were as following: Sociodemographic information form, Short Form-36 (SF-36) Quality of Life Scale, Hospital Anxiety and Depression Scale (HAD), Brief Symptom Inventory (BSI). Mann Whitney-U non-parametric test were used for statistical analysis. Results: There were 31 male, 36 female patients. Mean age in the hemodialysis group was 53.55 +/- 17.26 in the hemodialysis group and 47.83 +/- 13.76 in the CADP group. There no significant difference in the SF-36 sub-scales between two groups. According to the BSI sub-scales, there were significantly more somatization (p=0.027) and depression (p=0.045) in the HD group. All QoL subscales (except emotional role subscale in the anxiety group (p=0.186)) and BSI subscale points were statistically significantly worse among the patients who had over-threshold HAD anxiety and depression points. Conclusion: Psychiatric evaluation of chronic dialysis patients together with nephrologic evaluation seems quite important. Anxiety and/or depression, that cause deterioration in both QoL and psychiatric symptom distribution in these patients, can easily identified by quick and easily performed tests. By this way, psychiatric support can be provided to improve QoL, also psychiatric disorders can be early diagnosed, and thus necessary measures can be taken. Psychiatric evaluation and support seem to be very important and cannot be overlooked. By this means, caregiving "burn-out" syndrome can also be prevented. (Anatolian Journal of Psychiatry 2009; 10: 142-150)