School of Psychology, University College Dublin, Dublin, Ireland.
King's College Hospital NHS Trust, London, UK.
Nephrol Dial Transplant. 2023 Sep 29;38(10):2152-2159. doi: 10.1093/ndt/gfad021.
People with chronic kidney disease (CKD) experience high levels of psychological distress, which is associated with higher mortality and adverse health outcomes. Little is known about the rates of a range of mental health difficulties or rates of suicide attempts in people with CKD.
Individuals with CKD (n = 268; age range 18-94 years, mean = 49.96 years) on haemodialysis (n = 79), peritoneal dialysis (n = 46), transplant recipients (n = 84) and who were not on renal replacement therapy (RRT; n = 59) were recruited through the Irish Kidney Association social media pages and three Irish hospitals. Participants completed surveys to gather demographics and mental health histories, the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short Form Health Survey (SF-12) to measure health-related quality of life (HRQoL).
A total of 23.5% of participants self-reported they had received a mental health diagnosis, with depression (14.5%) and anxiety (14.2%) being the most common, while 26.4% of participants had experienced suicidal ideation and 9.3% had attempted suicide. Using a clinical cut-off ≥8 on the HADS subscales, current levels of clinically significant anxiety and depression were 50.7% and 35.4%, respectively. Depression levels were slightly higher for those on haemodialysis compared with those with a transplant and those not on RRT. Depression, anxiety and having a mental health diagnosis were all associated with lower HRQoL.
People with CKD in Ireland experience high levels of psychological distress, mental health difficulties, suicidal ideation and suicide attempts. The identification of and intervention for mental health difficulties in CKD should be prioritised in clinical care.
患有慢性肾病(CKD)的人会经历较高水平的心理困扰,这与更高的死亡率和不良健康结果有关。对于 CKD 患者的各种心理健康问题的发生率或自杀未遂率知之甚少。
通过爱尔兰肾脏病协会的社交媒体页面和三家爱尔兰医院招募了 268 名 CKD 患者(年龄 18-94 岁,平均年龄为 49.96 岁),包括血液透析患者(n=79)、腹膜透析患者(n=46)、移植受者(n=84)和未接受肾脏替代治疗(RRT;n=59)。参与者完成了调查,以收集人口统计学和心理健康史、医院焦虑和抑郁量表(HADS)和 12 项简短健康调查(SF-12),以衡量与健康相关的生活质量(HRQoL)。
共有 23.5%的参与者报告自己曾接受过心理健康诊断,其中抑郁症(14.5%)和焦虑症(14.2%)最为常见,而 26.4%的参与者有过自杀念头,9.3%的参与者曾试图自杀。使用 HADS 子量表上≥8 的临床切点,目前存在临床显著焦虑和抑郁的比例分别为 50.7%和 35.4%。与接受移植和未接受 RRT 的患者相比,血液透析患者的抑郁水平略高。抑郁、焦虑和有心理健康诊断均与较低的 HRQoL 相关。
爱尔兰的 CKD 患者经历了较高水平的心理困扰、心理健康问题、自杀念头和自杀未遂。在临床护理中应优先识别和干预 CKD 中的心理健康问题。