Psychiatric morbidity in end-stage renal disease patients’ on dialysis

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Background: In India, millions of people are suffering from chronic kidney disease (CKD). Hemodialysis imposes a variety of physical and psychosocial stressors that challenge not only the patients but also the caregivers. Psychiatric illness in patients with end-stage renal disease (ESRD) has persistently intrigued health-care workers due to its effect on morbidity and health-care costs in ESRD. Objective: The objective of this study was to assess psychiatric morbidity among ESRD patients on hemodialysis. Materials and Methods: The study enrolled 170 patients with ESRD undergoing hemodialysis. Psychiatric morbidity was assessed using Mini International Neuropsychiatric Interview. Results and Discussion: Of the 170 patients studied, 70.6% were males and 29.4% were females. The mean age of the patients was 40.8 (SD = 14.8). Psychiatric morbidity was present in 42(24.7%) patients. The common diagnosis was major depressive episode (n = 37) followed by generalized anxiety disorder (n = 3), dysthymia (n = 1), and alcohol dependence syndrome (n = 1). No significant association was seen between gender and marital status in psychiatric morbidity. Duration of renal illness had a significant association with psychiatric illness (P < 0.0001). A similar duration of dialysis also had an association with psychiatric illness (P < 0.0001) with a majority of patients having psychiatric complaints within 6 months of onset of dialysis. The presence of nonrenal comorbidities also had a significant association with psychiatric illness (P < 0.005). Conclusion: This study has shown psychiatric illness among patients with ESRD on hemodialysis and its association with various factors such as duration of renal illness, duration of dialysis, and the presence of comorbidities.