Abstract

AN OVERVIEW ON IMPACT OF PSYCHOLOGICAL FACTORS IN PATIENTS UNDERGOING DIALYSIS

Tahera Mubeen*, Maneesha Annavarapu, Naveen Yaradesi and Padmalatha Kantamneni

Abstract

Chronic kidney disease (CKD) also known as End stage renal disease (ESRD) is a commonest, debilitating, long standing public health condition. During the initial stages of CKD, treatment is mainly focused on slowing the progression of kidney damage and treating the complications. In the final stage, dialysis or renal transplantation becomes core responsible to maintain health. The most frequent psychopathological problems among patients undergoing dialysis are depression and anxiety which is still under recognized and misdiagnosed. The dialyzed patients are often subjected to depression and anxiety symptoms due to myriad physical, mental and psychosocial factors. Females are more prone to develop anxiety while males have high tendency to develop depression. The overall prevalence rate of depression and anxiety in dialyzed patients is about 66% and 61% respectively. Moreover, the mechanisms involved between psychological factors and adverse medical outcomes in dialyzed patients are discussed. Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) are some of the screening tools to diagnose depression and anxiety. Management of dialyzed patients with depression and anxiety is a key role to improve their quality of life. Besides pharmacological treatment, cognitive behavioral therapy and life style modifications have immense fortune on patient’s survival. More attention should be given to depression and anxiety care in context to dialyzed patients management. This review provides a selective overview on prevalence rate, etiology, coping mechanisms and treatment in complex patients and also management strategies are appraised and discussed from the relevant literature.

Keywords: Chronic kidney disease (CKD), End stage renal disease (ESRD), Depression, Anxiety, HADS.