Η ανίχνευση των ψυχικών διαταραχών σε ασθενείς με χρόνια νεφρική νόσο

Introduction: The impact of mental disorders on the outcome of patients with Chronic Kidney Disease (CKD) was started receiving special attention the last few decades. The gradual increase in both the prevalence and the incidence of end-stage CKD worldwide, the high mortality rate and increasing costs for the care of these patients have turned the research interest to those aspects of care which affect patient outcomes and possibly have the ability to modify and improve these results. It is generally accepted that patients with chronic diseases, such as kidney patients, present a significant burden of mental health, which directly affects their quality of life (QoL). A significant number of mental disorders, which occur during the progression of CKD or become evident after the initiation of dialysis, or even after transplantation. Depression is the most common psychological problem in patients with CKD. The review of the literature regarding the prevalence of these disorders in chronic kidney disease refers to a percentage of 20-30%. The aim of the present study was to investigate psychiatric morbidity in Greek population of CKD patients of different stages, severity and therapeutic intervention, as well as the assessment of their QoL. Patients and methods: One hundred and ninety patients in the Nephrology Departments of three Hospitals of Greece (University Hospital of Ioannina, University Hospital of Patras, Regional General Hospital “Papageorgiou” Thessaloniki). Specifically, the sample included 90 patients undergoing hemodialysis (HD), 39 patients undergoing Peritoneal Dialysis (PD), while 43 had CKD stages 1-4 and 18 were kidney transplant recipients. From them 122 were men and 68 women. The assessment of mental morbidity included diagnostic interview «Clinical Interview Schedule-Revised» (CIS-R) (Revised Clinical Diagnostic Interview). This is a structured interview, which is designed to be administered by interviewers who are not mental health professionals (psychiatrists, psychologists and mental health nurses). The assessment of QoL of patients with CKD was done using the SF-36 questionnaire. It is a general measuring tool of the results of medical care and widely used for assessment of QoL. Eight health parameters measured by this questionnaire are: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health.Results: The prevalence of mental disorders include: Depression 3,1%, Generalized Anxiety Disorder 4,2% Chronic Fatigue Syndrome 2.1% Panic disorder 1.5% Phobias 1%, Mixed Anxiety/Depressive Disorder 2.6%. The rate of major depression showed no differences between the sexes. Patients with CKD showed no more symptoms compared with the general population. Moreover were not recorded high the rates of depression. Regarding the 14 psychiatric symptoms, we found that sleep problems (31%), fatigue (24%), generalized anxiety/worry (18%) and anxiety/worry about physical health (17%) were the symptoms that had the highest rates among the study…