The influence of emotional factors on the report of somatic symptoms in patients on chronic haemodialysis: the importance of anxiety.
OBJECTIVE
To evaluate the prevalence of different somatic symptoms in chronic haemodialysis patients compared with a control group and to analyse the predictive capacity of some psychological variables (namely anxiety, depression, social support, self-efficacy and coping strategies) in the reporting of these symptoms.


METHODS
Forty-six patients undergoing dialysis treatment and 30 individuals without relevant illness, matched in socio-demographic variables, were evaluated with self-reported measures. Relationships between somatic symptoms and predictor variables were analysed through bivariate correlations and multiple regression analysis.


RESULTS
Patients showed much higher somatic symptom values than control individuals, especially with regard to immunological, cardiovascular, gastrointestinal and skin-allergy symptoms. Anxiety, with a positive association, was the main independent predictor in most of the symptom categories, explaining 24.9% (p<.0001) of variance in the total number of reported symptoms. Depression, the degree of worry, and passive coping strategies (helplessness-despair and fatalism) were also associated with higher levels of somatic symptoms. By contrast, the active coping strategy of fighting spirit, self-efficacy (coping capacity) and social support were associated with lower levels of symptoms.


CONCLUSIONS
These results have clinical implications with respect to the aspects on which psychological interventions intended to reduce somatic symptoms in chronic haemodialysis patients should be based and they suggest that psychological-emotional variables may explain some symptoms that do not have a clear aetiology in kidney patients.
Carmen M
CM
Perales-Montilla
Stefan
S
Duschek
Gustavo A
GA
Reyes-Del Paso
D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D001294:Attitude to Health; D058443:Catastrophization / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003863:Depression / Q000523:psychology; D004522:Educational Status; D004644:Emotions; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D000075384:Neuroticism; D006435:Renal Dialysis / Q000523:psychology*; D012649:Self Concept; D020377:Self Efficacy; D057566:Self Report; D012720:Severity of Illness Index; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D055815:Young Adult