Centro Universitario de la Cienega, University of Guadalajara, Ocotlán 47820, Mexico.
Nephrology Department, Civil Hospital de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico.
Int J Environ Res Public Health. 2021 Nov 14;18(22):11957. doi: 10.3390/ijerph182211957.
Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18-65 years. Beck's depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26-52) years vs. 30 (24.43) years, = 0.025), had a lower education level (36% vs. 9%, = 0.001), used more medications (67% vs. 36%, = 0.001), had a comorbidity (75% vs. 41%, = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.
抑郁和焦虑是终末期肾病（ESRD）中高度流行的心理障碍，对临床有负面影响。我们的研究目的是确定与接受血液透析的 ESRD 患者中抑郁和焦虑存在相关的因素。我们纳入了来自两家透析中心的 187 名年龄在 18-65 岁的患者。使用贝克抑郁和焦虑量表、KDQOL36 问卷、认知扭曲量表和墨西哥韧性量表进行评估。从病历中获取社会人口统计学和临床信息。143 名（76.4%）患者存在抑郁。患有抑郁的患者年龄更大（33（26-52）岁 vs. 30（24.43）岁， = 0.025），教育程度更低（36% vs. 9%， = 0.001），使用更多的药物（67% vs. 36%， = 0.001），合并症更多（75% vs. 41%， = 0.001），等待肾移植的比例更高。112 名（59.8%）患者存在焦虑。通过多变量分析，抑郁与较低的教育程度、无先前肾移植、焦虑、较高的认知扭曲、较低的心理韧性和较低的生活质量评分独立相关。总之，较低的心理韧性、较低的教育程度和较高的认知扭曲是 ESRD 患者抑郁和焦虑的相关因素。
