Liu Jing, Xia Ning-Ning, Wang Hongying, Yuan Yinying, Xiao Leijuan, Xiang Anne
Department of Nephrology, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Front Psychol. 2025 Jul 8;16:1570190. doi: 10.3389/fpsyg.2025.1570190. eCollection 2025.
This study aimed to investigate the prevalence of alexithymia among patients receiving maintenance haemodialysis (MHD) and whether it plays a role in the relationship between symptom burden and depression in this population.
The prevalence of depression among patients undergoing MHD is increasing. Numerous studies have found strong links between alexithymia, symptom burden, and the development of depression in this population. However, the underlying mechanisms and alexithymia's specific mediating role in the relationship between symptom burden and depression are poorly understood and have received little attention in the existing literature.
This study included 380 MHD patients in a haemodialysis center, with a mean age of 58.98 ± 13.86 years, using a self-designed patient general information questionnaire, disease-related information questionnaire, dialysis patient symptom burden scale, depression scale, and Toronto Alexithymia Scale (TAS-20). A regression model of the factors influencing depression was developed using structural equation modeling.
MHD patients had a DFSSBI score of 77.41 ± 45.74, a TAS-20 score of 55.36 ± 11.17, and a Patient Health Questionnaire (PHQ-9) score of 6.07 ± 4.60. The burden of symptoms was positively correlated with alexithymia and depression ( = 0.367, 0.776, = 0.000). The regression model had a high goodness of fit (χ/df = 1.604, RMSEA = 0.040, GFI = 0.986, CFI = 0.999, TLI =0.997). The structural equation model analysis found the following: symptom burden was a positive predictor of alexithymia, β = 0.296, < 0.001; alexithymia was a positive predictor of depression, β = 0.752, < 0.001; and symptom burden was a positive predictor of depression, β = 0.141, < 0.001.
The level of depression in MHD patients is closely related to the burden of symptoms and alexithymia, with alexithymia serving as a partial intermediary between the two. Addressing the emotional wellbeing and symptom load of MHD patients is critical to relieving their depressive symptoms.
本研究旨在调查维持性血液透析（MHD）患者中述情障碍的患病率，以及其在该人群症状负担与抑郁之间的关系中是否起作用。
接受MHD治疗的患者中抑郁症的患病率正在上升。许多研究发现述情障碍、症状负担与该人群抑郁症的发生之间存在紧密联系。然而，潜在机制以及述情障碍在症状负担与抑郁关系中的具体中介作用仍了解甚少，且在现有文献中很少受到关注。
本研究纳入了一家血液透析中心的380例MHD患者，平均年龄为58.98±13.86岁，使用自行设计的患者一般信息问卷、疾病相关信息问卷、透析患者症状负担量表、抑郁量表和多伦多述情障碍量表（TAS-20）。采用结构方程模型建立影响抑郁的因素回归模型。
MHD患者的透析患者症状严重程度总评量表（DFSSBI）得分为77.41±45.74，TAS-20得分为55.36±11.17，患者健康问卷（PHQ-9）得分为6.07±4.60。症状负担与述情障碍和抑郁呈正相关（r = 0.367，0.776，P = 0.000）。回归模型具有较高的拟合优度（χ²/df = 1.604，RMSEA = 0.040，GFI = 0.986，CFI = 0.999，TLI = 0.997）。结构方程模型分析发现：症状负担是述情障碍的正向预测因子，β = 0.296，P < 0.001；述情障碍是抑郁的正向预测因子，β = 0.752，P < 0.001；症状负担是抑郁的正向预测因子，β = 0.141，P < 0.001。
MHD患者的抑郁水平与症状负担和述情障碍密切相关，述情障碍在两者之间起部分中介作用。关注MHD患者的情绪健康和症状负荷对于缓解其抑郁症状至关重要。
