Investigation of minor psychiatric symptoms in patients with chronic kidney disease on hemodialysis treatment

Abstract

AIMS: To identify sociodemographic characteristics and presence of minor symptoms of anxiety and depression in patients on hemodialysis. METHODS: Cross-sectional study, carried out in the hemodialysis units of the Santas Casas de Misericórdia in Marília and Tupã, São Paulo state, Brazil, with 65 hemodialytic patients, ranging from 20 to 86 years. Initially, the mental state of the participants was evaluated in order to ensure they had conditions to understand the research objectives and to respond to the evaluation instruments. Following, the subjects answered to the socio-demographic and clinical questionnaire and the Hospital Anxiety and Depression Scale. The data were organized using relative and absolute frequencies for the categorical variables, and measures of central tendency and dispersion for the quantitative variables. In order to compare the mean scores according to the studied variables, unpaired Student's t test and Analysis of Variance were used in addition to Mann Whitney U-Test and Kruskal-Wallis test when the distribution did not present normality. The adopted level of significance was 5% (p < 0.05). RESULTS: The Hospital Anxiety and Depression Scale for minor symptoms identified 42 patients with anxiety and 45 with depression. The anxiety mean scores were statistically higher in the female (10.23±4.51) than in the male (8.32±3.68) patients (p=0.034). Patients aged 31 to 41 years and 42 to 52 years had higher depression scores (12.20±1.48 and 11.16±2.50 respectively) when compared to patients aged over 52 years (9.23±3.63) and aged 20 to 30 years (5.50±2.12) (p=0.017). Patients who underwent psychotherapeutic treatment had lower scores of anxiety (1.00±1.41) compared to those who had already undergone psychotherapeutic treatment and those had never been under treatment (9.27±3.92 and 12.75±3.40 respectively) (p=0.020). CONCLUSIONS: According to the Hospital Anxiety and Depression Scale, women had higher anxiety mean scores than men. The lowest scores for anxiety and depression were present in the younger and older age groups of women, and those who underwent psychotherapy presented even lower scores. Clinical management in psychotherapy can be a positive contribution to ease the symptoms of anxiety and depression, improving the patients' ability to cope with hemodialysis.