Anxiety and depression in patients on hemodialysis

OBJECTIVE To explore the extent of anxiety and depression experienced by patients on hemodialysis. METHOD The study included 320 patients undergoing routine hemodialysis in dialysis units who completed a specially designed questionnaire which covered socio-demographic and clinical characteristics and included the Hospital Anxiety and Depression Scale (HADS). RESULTS According to their scores on HADS, 41.3% of the participants had high anxiety levels and 32.2% high levels of depression. Significant correlation was demonstrated between the level of anxiety and gender (p=0.013), the residence (p=0.005), the number of children (p=0.006), the quality of the relations with the medical and nursing staff and other patients (p<0.001), difficulty in relationships within the family and social environment (p<0.001), concealment of the problem from the community (p<0.001) and the provision of home assistance for everyday life activities (p<0.001). Factors found to influence the levels of depression were age (p=0.028), educational level (p=0.018), place of residence (p<0.001), the years since the onset of the health problem (p=0.03), adherence to treatment guidelines (p=0.001), adherence to the proposed diet (p<0.001), the relation with the medical and nursing staff and other patients (p<0.001), difficulties in relationships within the family and the community (p<0.001), provision of help at home (p<0.001), and concealment of the health problem from the community (p<0.001). CONCLUSIONS A variety of socio-demographic and clinical characteristics are closely related to the anxiety and depression experienced by patients undergoing hemodialysis.