Mental Health Impact On Patients of ESRD On Renal Replacement Therapy: A Cross Sectional Survey Using Beck and Deck Inventory

Abstract

Introduction: Chronic kidney disease (CKD) affects approximately 8 to 16% of population worldwide. With increasing incidence of diabetes mellitus and an aging population, CKD is putting an enormous burden on health care resources.

The prevalence of CKD in Pakistan has been estimated to vary between 5%-12.5%. Depression can be found in 25% to 42% of hemodialysis patients. There are no previous studies done in Pakistan to know the mental health impact in End- stage renal disease (ESRD)patients undergoing dialysis.

Aims &Objectives: To assess the mental health impact on patients of ESRD on renal replacement therapy using Beck and Deck inventory in our population.

Place and duration of study: Department of Medicine, Ayub Teaching Hospital, Abbottabad from February 2019 to July 2019.

Material & Methods: 97 patients were enrolled using non-probability, consecutive sampling. Patients having CKD and on dialysis for 3 months from both genders from ages 15 to 60 years were included in the study. Patients were assessed using DSM-IV/BDI criteria for presence of depression. Data was entered and analyzed using SPSS version 20

Results: Of the 97 patients included in the study 57 (58.8%) were male and 40 (41.2%) were females. The mean age of patients was 45.00 ±14.82 years. The mean length of time since the patients were on dialysis was 20.47 ±22.81 months. Hypertension was the commonest cause of CKD (75.3%). The mean BDI score was 15.25 ±7.46. The number of patients who had no or minimal depression was 40 (41.2%). The number of patients having mild, moderate and severe depression was 57 (58.8%) patients. Single patients were more likely to be normal (77.8%) compared to married individuals (37.5%). Of the patients who were on dialysis for more than 48 months, 75% were normal with no element of depression. Of the patients who were on dialysis for less than a year, 59.6% had depression. This was statistically significant.

Conclusion: Depression is more prevalent in ESRD patients on hemodialysis. It is more prevalent than found in other major illnesses and in the general population. It should be recognized earlier so that these patients can be treated, and they can have a better quality of life.