Depression and anxiety in hemodialysis patients

Objective: To explore the magnitude o f depression and anxiety in hemodialysis patients. Methodology: This cross sectional study was carried out from March to August 2019 at the hemodialysis units of Al Alamgir International Welfare Trust and Karachi Institute of Kidney Disease. All patients >18 years on hemodialysis for more than 6 months were included in the study. Patient with known psychiatric illness or neurological illness, on antidepressant and antianxiety medication, with any kind of addiction (Alcohol, illicit drugs) were excluded. Hospital anxiety depression scale (HADS) was used to assess the presence of anxiety and depression and their severity. A score 11-21 was considered abnormal disorder, a score of 8-10 borderline abnormal and a score 0-7 normal and indicated absence of disorder. Results: Total 156 patients completed the questionnaire. Majority of the participants (52.9%) were male while (47.1%) female. About 43.6% were undergoing hemodialysis in morning, 39.1 % in afternoon and 17.3% in evening. Only (17.3%) of the participants were smokers while rest of the patients had no history of smoking. Out of 156 participants 50.6% of the participants had anxiety (14.74% had borderline anxiety and 35.9% had abnormal anxiety) while 55.8% had depression (26.3% had borderline depression and 29.5% had abnormal depression). Female participants were more anxious than male (p<0.004) and married had statistically significant anxiety (p<0.032). Conclusion: Depression and anxiety is frequently found in patients with hemodialysis. Screening for symptoms of depression and anxiety should be part of routine care in patients with hemodialysis as timely diagnosis and management helps in improving the quality of life.