Koushik Bhattacharjee, Atanu Pal, Arabinda Das
Arpita Ray Chaudhury, Debabrata Sen Acharya Prafulla Chandra College,
Dourav Shristi Kolkata
Institute of Post Graduate Medical Education
& Research, Kolkata
Background: Depression and anxiety are the most common psychiatric condition
in Chronic Kidney Disease (CKD) patients. However, most of the studies evaluated
patients in terminal stage of the disease and research assessing patients under predialysis treatment are scarce. This article aims to evaluate the spectrum of anxiety and
depression among CKD patients of stage 3-5 and 5D. Materials and methods: We
evaluated 104 CKD patients (CKD stages 3- 5D) in a hospital based cross sectional
observation study at department of Nephrology, SSKM Hospital & IPGMER, Kolkata
during February, 2015 to December, 2016. Information on socio-demographic and
clinical characteristics were collected for each patient preparing a detailed questionnaire.
Symptoms of anxiety and depression were assessed using the Hospital Anxiety and
Depression Scale (HADS), Beck’s Depression Inventory and Hamilton Anxiety Rating
Scale (HAM-A). Results: Among CKD patients 82 (78.84%) patients had some form of
depression and 80 (76.92%) were suffering from clinical anxiety. Almost 21.15% of the
patients perceived that they are living in the condition of poor social support, the rest i.e.
78.84% perceived it to be good and they get help from relatives and neighbours in case
of need. Depression and anxiety were significantly associated with perceived social
support, monthly income, duration of dialysis and creatinine level. Female had higher
prevalence of developing depression (OR = 1.934; 95% CI: 0.825–4.284) and anxiety
(OR = 1.648; 95% CI: 0.823–4.255) among CKD patients. Patients from nuclear family
had significantly higher prevalence of developing depression. The odds of developing
depression in patients with poor social support were 9.277 times higher (OR = 9.277;
95% CI: 1.673–70.356). Monthly income was highly associated with higher prevalence
of developing depression (OR = 1.937; 95% CI: 1.022–3.283) and anxiety (OR = 1.736,
95% CI: 0.821–2.937). The odds of developing depression and anxiety with duration of
dialysis among CKD patients were 2.328 times (95% CI: 1.106-3.349) and 3.232 times
(95% CI: 1.628-7.283) higher. Creatinine level were associated with higher prevalence
of developing depression (OR = 1.934; 95% CI: 1.092–2.845) and anxiety (OR = 2013;
95% CI: 1.134–3.744). Conclusion: Depression and anxiety were associated with some
clinical and socio-demographic variables viz. perceived social support, monthly income,
duration of dialysis, type of family and creatinine level.
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