The features of psychological problems and their significance in patients on hemodialysis--with reference to social and somatic factors.
OBJECTIVE
For the purpose of identifying the features of psychological problems and their significance in patients on hemodialysis, we analyzed how psychological problems are affected by social and somatic factors.


METHODS
The subjects all consisted of patients on hemodialysis at the Kidney Center of Fukuoka Red Cross Hospital between December 1994 and December 1996. We used the Cornell medical index health questionnaire on neurosis and the "easily upset or irritated", State-trait anxiety inventory to determine both state and trait anxiety, the Self rating Depression Scale on depression and divided into the patients who demonstrated each psychological problem and those who did not, and then analyzed the psychological problems between the two groups with reference to somatic and social factors which may have led the patients to develop their respective psychological problems.


RESULTS
According to a chi-square analysis, neurosis, clinical trait anxiety and clinical state anxiety were all more closely related to somatic factors than to social factors. In contrast to neurosis and anxiety, more social factors than somatic factors were related with "easily upset or factors were related with" easily upset or irritated". "Easily upset or irritated" was significantly related to living with a spouse or with children. In addition, depression was related to various factors including both somatic and social factors. In a stepwise multiple logistic regression analysis, the presence of restless legs also correlated with all the psychological symptoms investigated in this study. The prevalence of depression was also related to the degree of awareness regarding the cause of renal failure (p < 0.01).


CONCLUSIONS
Our results thus revealed the features of the psychological problems and their significance in patients on hemodialysis.
Tanaka
K
K
Department of Neuropsychiatry, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Morimoto
N
N
Tashiro
N
N
Hori
K
K
Katafuchi
R
R
Fujimi
S
S
D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000209:etiology*; D011581:Psychological Tests; D006435:Renal Dialysis / Q000523:psychology*; D051437:Renal Insufficiency / Q000523:psychology / Q000628:therapy; D012148:Restless Legs Syndrome / Q000209:etiology; D012959:Socioeconomic Factors