Balaban Özlem Devrim, Aydin Erkan, Keyvan Ali, Yazar Menekşe Sıla, Tuna Özgecan, Devrimci Özgüven Halise
Department of Psychiatry, Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey.
Clinic of Psychiatry, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.
Noro Psikiyatr Ars. 2017 Jun;54(2):137-142. doi: 10.5152/npa.2016.12677. Epub 2017 Jan 19.
Due to disabilities caused by the disease and the requirement of dialysis, end-stage renal disease (ESRD) is frequently comorbid with psychiatric disorders, adversely affects quality of life, and causes significant sexual dysfunction (SD). We aimed to investigate the psychiatric comorbidity, quality of life, depression and anxiety levels, and SD in ESRD patients undergoing hemodialysis.
Forty-nine patients undergoing hemodialysis treatment in a dialysis center and 44 non-ESRD control subjects selected with snowball sampling were enrolled in the study. All subjects were assessed using Structured Clinical Interview for Axis-I Disorders (SCID-I). Sociodemographic data form, Hospital Anxiety and Depression Scale (HADS), Arizona Sexual Experience Scale (ASEX), and World Health Organization Quality of Life Short Form Turkish Version Scale (WHOQOL-BREF-TR) were applied to both groups.
There was no difference between the groups in terms of sex, age, education period, marital status, presence of additional physical illness, and past history of psychiatric disorders. Compared with the control group, HADS depression subscale and ASEX scores were significantly high (p<0.01) in the patient group, and WHOQOL-BREF-TR psychological and physical domain scores were low (p<0.05 and p<0.01, respectively). There was a significant negative relationship between HADS scores and WHOQOL-BREF-TR psychological, environmental, and national environmental scores in the patient group (p<0.05). When the differences between the groups were re-analyzed after controlling HADS depression scores with covariance analysis, the significant difference in ASEX and WHOQOL-BREF-TR physical domain scores between the groups remained, but the significant difference in WHOQOL-BREF-TR psychological domain scores disappeared.
The quality of life of ESRD patients was lower, especially in the psychological and physical domains, and psychiatric comorbidities and SD rates were higher than in non-ESRD control subjects. Quality of life is affected by SD. Recognizing and treating depressive symptoms will help improve the quality of life, especially in the psychological domain.
由于疾病导致的残疾以及透析的需求，终末期肾病（ESRD）常合并精神障碍，对生活质量产生不利影响，并导致显著的性功能障碍（SD）。我们旨在调查接受血液透析的ESRD患者的精神共病情况、生活质量、抑郁和焦虑水平以及性功能障碍。
本研究纳入了在透析中心接受血液透析治疗的49例患者以及通过滚雪球抽样选取的44例非ESRD对照受试者。所有受试者均使用轴I障碍的结构化临床访谈（SCID-I）进行评估。两组均应用社会人口学数据表、医院焦虑抑郁量表（HADS）、亚利桑那性体验量表（ASEX）以及世界卫生组织生活质量简表土耳其语版量表（WHOQOL-BREF-TR）。
两组在性别、年龄、受教育年限、婚姻状况、是否存在其他躯体疾病以及精神障碍既往史方面无差异。与对照组相比，患者组的HADS抑郁子量表和ASEX评分显著更高（p<0.01），而WHOQOL-BREF-TR心理和生理领域评分较低（分别为p<0.05和p<0.01）。患者组中HADS评分与WHOQOL-BREF-TR心理、环境和总体环境评分之间存在显著负相关（p<0.05）。在用协方差分析控制HADS抑郁评分后重新分析两组之间的差异时，两组之间ASEX和WHOQOL-BREF-TR生理领域评分的显著差异仍然存在，但WHOQOL-BREF-TR心理领域评分的显著差异消失。
ESRD患者的生活质量较低，尤其是在心理和生理领域，精神共病和性功能障碍发生率高于非ESRD对照受试者。生活质量受性功能障碍影响。识别并治疗抑郁症状将有助于提高生活质量，尤其是在心理领域。
