Department of Psychiatry, Oslo University Hospital Ullevål, 0407 Oslo, Norway.
Gen Hosp Psychiatry. 2011 Sep-Oct;33(5):454-61. doi: 10.1016/j.genhosppsych.2011.06.010. Epub 2011 Aug 9.
The objective of the study was to identify the prevalence of depression, anxiety and somatoform disorders in dialysis patients according to dialysis modality and to compare dialysis patients with and without psychiatric comorbidity regarding clinical characteristics, health-related quality of life (HRQoL) and markers of nutrition and inflammation.
One hundred and nine patients were assessed for depression, anxiety and somatoform disorder with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The Short Form 36 was used. Sociodemographic, clinical and laboratory data were collected.
About one third, 30.3%, had a current psychiatric disorder regardless of dialysis modality (depression, 22%; anxiety, 17%; somatoform disorders, 1%), and these reported more impairment on HRQoL dimensions. In the multivariate analysis, significant correlations between psychiatric comorbidity and C-reactive protein (CRP≥6 mmol/L) [odds ratio (OR), 3.6; 95% confidence interval (CI), 1.3-9.9; P=.015] and body mass index (BMI≤21 kg/m(2)) (OR, 4.2; 95% CI, 1.4-12.7; P=.011) were observed.
Depressive and anxiety disorders were common in dialysis patients and were associated with impaired HRQoL, while prevalence of somatoform disorders was low. A strong correlation between psychiatric comorbidity, CRP and BMI indicates that special attention should be given to patients with CRP≥6 mmol/L and BMI≤21 kg/m(2).
本研究旨在根据透析方式确定透析患者中抑郁、焦虑和躯体形式障碍的患病率，并比较伴或不伴精神共病的透析患者的临床特征、健康相关生活质量（HRQoL）以及营养和炎症标志物。
采用《精神障碍诊断与统计手册》第四版定式临床访谈对 109 例患者进行抑郁、焦虑和躯体形式障碍评估。使用 36 项简短健康调查问卷。收集社会人口统计学、临床和实验室数据。
约三分之一（30.3%）的患者无论透析方式如何（抑郁 22%，焦虑 17%，躯体形式障碍 1%）均存在当前精神障碍，这些患者在 HRQoL 维度上的损害更为明显。在多变量分析中，精神共病与 C 反应蛋白（CRP≥6 mmol/L）[比值比（OR），3.6；95%置信区间（CI），1.3-9.9；P=.015]和体质指数（BMI≤21 kg/m²）（OR，4.2；95% CI，1.4-12.7；P=.011）之间存在显著相关性。
抑郁和焦虑障碍在透析患者中很常见，且与 HRQoL 受损相关，而躯体形式障碍的患病率较低。精神共病、CRP 和 BMI 之间的强相关性表明，应特别关注 CRP≥6 mmol/L 和 BMI≤21 kg/m² 的患者。
