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在阿姆哈拉州转诊医院就诊的成年慢性肾脏病患者的常见精神障碍及相关因素。

Common mental disorders and associated factors among adult chronic kidney disease patients attending referral hospitals in Amhara Regional State.

机构信息

Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Health Education and Behavioral Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Sci Rep. 2024 Mar 21;14(1):6812. doi: 10.1038/s41598-024-57512-1.

Abstract

Common mental disorders (CMDs) are a wide term that includes disorders like depression, anxiety, and somatic manifestations. Chronic kidney disease (CKD) patients are at high risk of developing a common mental disorders, which leads to a lower survival rate, poor clinical outcome, longer hospitalization, increased health-care utilization, difficulty adhering to medications, an increased risk of initiation of dialysis, poor quality of life, and an increased risk of mortality. However, there is limited study done related to common mental disorders and associated factors among chronic kidney disease patients in Ethiopia. This study aimed to assess the prevalence of common mental disorders and associated factors among chronic kidney disease patients attending referral hospitals in Amhara Regional State. An institution-based cross-sectional study design was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals from January to April 2020. The study participants were selected using systematic random sampling techniques. Common mental disorders were assessed using the Self-Reporting Questionnaire-Falk Institute (SRQ-F) tool. Data were entered into Epi Data Version 3.0 then exported into STATA 14 for analysis. Both bivariable and multi-variable binary logistic regressions were done to identify factors associated with common mental disorders. In multivariable logistic regression analysis, variables with a p-value of ≤ 0.05 were declared as a statistically associated with common mental disorders. In this study, 424 CKD patients were included, with a response rate of 100%. Among screened CKD patients, 40.8% was positive for common mental disorders, with a 95% CI (36-45%). Independent predictors of common mental disorders among CKD patients were poor social support [(AOR 3.1, 95% CI (1.67-5.77)], family history of mental disorders, [AOR 3.6, 95% CI (1.12-11.8)], comorbidity [AOR 1.7, 95% CI (1.03-2.78)], being female [AOR 2.69, 95% CI (1.72-4.20)], and duration of CKD (AOR 3.5; 95% CI (2.28-5.54). Two out of five CKD patients screened for CMDs were found to be positive. Common mental disorders were more common among CKD patients with poor social support, a family history of mental disorders, comorbidity, being female, and the duration of CKD. Therefore, screening CKD patients for common mental disorders is recommended.

摘要

常见精神障碍(CMDs)是一个广泛的术语,包括抑郁症、焦虑症和躯体表现等疾病。慢性肾脏病(CKD)患者患常见精神障碍的风险很高,这导致生存率降低、临床预后不良、住院时间延长、医疗保健利用率增加、难以坚持用药、开始透析的风险增加、生活质量下降和死亡率增加。然而,在埃塞俄比亚,与慢性肾脏病患者常见精神障碍及相关因素相关的研究有限。本研究旨在评估在阿姆哈拉州转诊医院就诊的慢性肾脏病患者常见精神障碍的患病率及相关因素。这是一项 2020 年 1 月至 4 月在贡德尔大学综合专科医院和费莱吉·希沃特转诊医院进行的基于机构的横断面研究设计。采用系统随机抽样技术选择研究参与者。使用 Falk 研究所自我报告问卷(SRQ-F)工具评估常见精神障碍。数据录入 EpiData 版本 3.0 后导出到 STATA 14 进行分析。采用单变量和多变量二元逻辑回归分析确定与常见精神障碍相关的因素。在多变量逻辑回归分析中,p 值≤0.05 的变量被宣布为与常见精神障碍有统计学关联。在这项研究中,共纳入了 424 名 CKD 患者,应答率为 100%。在筛选出的 CKD 患者中,有 40.8%的患者存在常见精神障碍,95%置信区间(CI)为(36-45%)。CKD 患者常见精神障碍的独立预测因素包括社会支持差(AOR 3.1,95%CI(1.67-5.77))、精神障碍家族史(AOR 3.6,95%CI(1.12-11.8))、合并症(AOR 1.7,95%CI(1.03-2.78))、女性(AOR 2.69,95%CI(1.72-4.20))和 CKD 持续时间(AOR 3.5;95%CI(2.28-5.54))。在筛查出的 CMDs 患者中,有两成以上被发现呈阳性。社会支持差、精神障碍家族史、合并症、女性和 CKD 持续时间是 CKD 患者常见精神障碍更常见的原因。因此,建议对 CKD 患者进行常见精神障碍的筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25f3/10957902/e8c0cfab908a/41598_2024_57512_Fig1_HTML.jpg

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