Qanakkale Onsekiz Mart University School of Medicine, Turkey.
Int J Psychiatry Med. 2012;43(3):227-41. doi: 10.2190/PM.43.3.c.
Depression is the most widely studied complication in dialysis patients. In patients with chronic renal failure, changes in body image are considered to be associated with invasive treatment interventions. In addition, sexual problems are common in dialysis patients. In this study, hemodialysis and peritoneal dialysis patients are investigated for depression, anxiety, body image, sexual satisfaction, and dyadic adjustment.
Hemodialysis patients (n = 36), peritoneal dialysis patients (n = 54), and healthy controls (n = 30) were included in the study. All the subjects were assessed with Structured Clinical Interview for DSM-IV, Body Image Scale, Beck Depression Inventory, Beck Anxiety Scale, Golombok-Rust Inventory for Sexual Satisfaction, and Dyadic Adjustment Scale.
Depression (20.64 +/- 15.20) and anxiety levels (14.72 +/- 12.36) were significantly higher in hemodialysis group compared to peritoneal dialysis (13.54 +/- 12.51; 12.74 +/- 11.21) and control groups (7.17 +/- 5.58; 9.86 +/- 9.19). In peritoneal dialysis group, as depression and anxiety levels increased, body image was disturbed and sexual satisfaction decreased. In peritoneal dialysis group, body image (86.98 +/- 23.63) was better than hemodialysis group (101.58 +/- 26.51) and was not different from the control group (83.67 +/- 22.11). In hemodialysis group, as depression and anxiety levels increased, body image was disturbed. In both groups, long-term dialysis disturbed body image.
Patients should be informed about the impacts of dialysis. Clinicians may wish to monitor dialysis-users for anxiety, depression, dyadic adjustment, and body image difficulties at follow-up appointments. Interventions that target intimate partner interventions, appearance-related beliefs, and anxiety depression may be of benefit to this population.
抑郁症是透析患者中研究最广泛的并发症。在慢性肾衰竭患者中，身体形象的变化被认为与侵入性治疗干预有关。此外，透析患者中常见性问题。在这项研究中，对血液透析和腹膜透析患者进行了抑郁、焦虑、身体形象、性满意度和对偶调整的研究。
纳入了血液透析患者（n=36）、腹膜透析患者（n=54）和健康对照组（n=30）。所有患者均采用 DSM-IV 结构临床访谈、身体形象量表、贝克抑郁量表、贝克焦虑量表、戈勒姆-拉斯特性满意度量表和对偶调整量表进行评估。
与腹膜透析组（13.54±12.51；12.74±11.21）和对照组（7.17±5.58；9.86±9.19）相比，血液透析组的抑郁（20.64±15.20）和焦虑水平（14.72±12.36）显著升高。在腹膜透析组中，随着抑郁和焦虑水平的升高，身体形象受到干扰，性满意度下降。在腹膜透析组中，身体形象（86.98±23.63）优于血液透析组（101.58±26.51），与对照组（83.67±22.11）无差异。在血液透析组中，随着抑郁和焦虑水平的升高，身体形象受到干扰。在这两组中，长期透析都会干扰身体形象。
应告知患者透析的影响。临床医生可能希望在随访时监测焦虑、抑郁、对偶调整和身体形象困难等情况。针对亲密伴侣干预、外貌相关信念和焦虑抑郁的干预措施可能对这一人群有益。
