Prevalence of depression and anxiety in end-stage renal disease patients undergoing hemodialysis at AUBMC

Abstract

End stage renal disease (ESRD) is a chronic disease that requires lifelong treatment. One treatment used for ESRD is dialysis, which puts the patients under multiple stressors that impact their physical, psychological and emotional capabilities. Depression and anxiety are common disorders in dialysis patients, affecting their quality of life, morbidity, mortality, and hospitalization stay. In Lebanon, studies concerning the prevalence of depression and anxiety in this population are scarce. The purpose of this study is to describe the prevalence of these disorders among patients receiving hemodialysis at the American University of Beirut Medical Center (AUBMC). A convenience sample of 83 patients receiving hemodialysis at AUBMC, was recruited while undergoing their dialysis. Informed consents were obtained then patients were interviewed using the Hospital Anxiety and Depression Scale (HADS), in addition to demographic and clinical questions. The sample included mostly married men over 60 years of age, with 60percent from Beirut and 48percent having at least high school education. The prevalence of depression and anxiety were 40.8percent and 39.6percent, respectively, with 20 patients (24.1percent) having both conditions. Also, 24.1percent self-reported having anxiety symptoms but only 2.4percent were taking anxiolytics. Illiterate patients had significantly higher depression scores than those with higher levels of education (p = 0.021), but those who were working tended to have lower depression scores (p=0.09). Patients who were living with their family had significantly higher anxiety scores than those living alone or with a maid (p=0.014), but those older than 60 years tended to have lower anxiety scores (p=0.09). The findings suggest that anxiety and depression are underdiagnosed and undertreated in this sample. Since early diagnosis can help reduce the negative effects of anxiety and depression, the evidence provided supports the need for a psychiatric advance practice nurse, and-or psychologist-psychiatrist with the interdisciplinary team cari