Psychiatric morbidity in patients with chronic kidney disease: A cross sectional study

OBJECTIVES: Chronic kidney disease is a public health problem that has serious impact on quality of patient’s life. The aim of this study is to assess the prevalence of psychiatric morbidity in patients with chronic kidney disease and to assess the support systems, functional level, treatment adherence in relation to psychiatric illness and the nature and severity of psychiatric manifestations in patients with CKD on various treatment groups. METHODS AND MATERIALS: In this cross sectional observation study, 110 consecutive patients getting various treatments (conservative treatment, hemodialysis, renal transplantation) at nephrology department in Govt. Kilpauk Medical College, fulfilling the inclusion and exclusion criteria were included. Symptom Check List 90 to screen for psychiatric disorders applied, ICD 10 guidelines used for diagnosis of psychiatric disorders, Hamilton Depression rating scale and Hamilton Anxiety rating scale used for assessing the severity of depressive and anxiety disorders respectively. Severity of alcohol dependence questionnaire score was used to assess the severity of alcohol dependence. Montreal cognitive assessment was used for assessing cognitive functions. Multidimensional scale of perceived social support system, Karnofsky performance scale were also applied for assessing the support system, functional ability respectively. RESULTS: Of 110 patients, 36.4% (n=40) were in conservative treatment, 31.8% (n= 35) were in hemodialysis, 31.8% (n=35) were in renal transplantation. 47 (42.7%) had at least one psychiatric illness. Among the patients with psychiatric illness, Depressive disorder was present in 18 (38.3%) patients and 1 patient (2.1%) had depressive disorder with psychotic symptoms, 3 (6.4%) had anxiety disorder, 15 (31.9%) had adjustment disorder, 7 (14.9%) had alcohol dependence syndrome, 3 (6.4%) had psychosis. Among groups 21 (52.5%) patients in conservative treatment, 15 (42.9%) patients in hemodialysis, 11 (31.4%) post renal transplantation patients had psychiatric illness. Regarding support system, 68.6% had high social support in renal transplantation, but 45.7% , 40% in hemodialysis and in conservative treatment respectively. Regarding functional ability all 35 (100%) patients in post renal transplantation are able to do normal activities as previously. Whereas only 75%, 65.7% patients able to carry on normal activities in conservative and hemodialysis treatment respectively. Patients in renal transplantation had high treatment adherence than other 2 groups. CONCLUSION: This study has been helpful in understanding the psychiatric illness among the CKD patients.