Ćwiek Aleksandra, Czok Marcelina, Kurczab Bartłomiej, Kramarczyk Krzysztof, Drzyzga Karolina, Kucia Krzysztof
Department of Psychiatry and Psychotherapy, School of Medicine in Katowice, Medical University of Silesia, Ziołowa 45-47, Katowice, Poland,
Psychiatr Danub. 2017 Sep;29(Suppl 3):499-503.
Depression is the most common and serious psychiatric disorder that affects patients with chronic kidney disease and end-stage renal disease, and, has a significant impact on their quality of life. The aim of this study was to investigate and compare prevalence rates of depression among hemodialyzed patients, and non-dialyzed patients with a glomerular filtration rate<30 ml/min/1.73m receiving conservative treatment or following kidney transplantation. A total of 50 hemodialyzed and 50 non-dialyzed patients with stage 4/5 of CKD was assessed using the following questionnaires: Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), The Satisfaction with Life Scale (SWLS), The Acceptance of Illness Scale (AIS), and The Life Orientation Test-Revised (LOT-R). The use of steroids and immunosuppressant drugs was also investigated. Symptoms of depression and anxiety were present in both groups, however the proportion of persons with mild or severe depression was higher among dialyzed patients. The AIS, LOT-R and SWLS scores were very similar in both the groups. The patients using steroids and/or immunosuppressant drugs were more prone to develop mild or severe depression according to the HAM-D scores. The results indicated a high prevalence of depression and anxiety among patients with CKD. Furthermore, the fraction of patients with depression is greater among hemodialyzed patients. This indicates the importance of monitoring the mental state of the patients as well as the necessity of providing timely psychological care for patients with CKD.
抑郁症是影响慢性肾脏病和终末期肾病患者的最常见、最严重的精神障碍，对他们的生活质量有重大影响。本研究的目的是调查和比较接受血液透析的患者、肾小球滤过率<30 ml/min/1.73m接受保守治疗或肾移植后的未透析患者中抑郁症的患病率。使用以下问卷对总共50名接受血液透析的慢性肾脏病4/5期患者和50名未透析患者进行了评估：汉密尔顿焦虑评定量表（HAM-A）、汉密尔顿抑郁评定量表（HAM-D）、生活满意度量表（SWLS）、疾病接受量表（AIS）和修订后的生活取向测试（LOT-R）。还调查了类固醇和免疫抑制药物的使用情况。两组患者均存在抑郁和焦虑症状，但透析患者中轻度或重度抑郁患者的比例更高。两组患者的AIS、LOT-R和SWLS评分非常相似。根据HAM-D评分，使用类固醇和/或免疫抑制药物的患者更容易出现轻度或重度抑郁。结果表明，慢性肾脏病患者中抑郁和焦虑的患病率很高。此外，血液透析患者中抑郁症患者的比例更大。这表明监测患者心理状态的重要性以及为慢性肾脏病患者提供及时心理护理的必要性。
