title: Prevalence and impact of anxiety and depression in Chinese peritoneal dialysis patients: A single centre study.
abstract: OBJECTIVE
  Anxiety and depression are prevalent among patients with end stage renal failure. However, data concerning their role in the subsequent peritonitis and hospitalization was scarce. The aim of this study was to examine the prevalence of psychological problems in our Chinese peritoneal dialysis (PD) patients and its association with subsequent clinical outcome.
  
  
  METHODS
  This was a single-centre prospective cohort study. All patients newly started on PD between 1 September 2012 and 31 December 2014 were recruited. Hospital Anxiety Depression Scale was used to categorize the patients into high score group (HSG) and low score group (LSG). Higher score reflects higher emotional distress.
  
  
  RESULTS
  A total of 132 patients were recruited. Seventy-five patients (55%) were categorized as HSG. Higher overall peritonitis rate and Gram-positive organism associated peritonitis rate were observed in HSG (P = 0.012 and P = 0.016, respectively). The hospitalization rates in HSG and LSG were 1.20 episodes per patient-year and 1.05 episodes per patient-year respectively. Both high CCI (OR 1.33, 95% CI 1.10-1.62, P < 0.01) and HSG (OR 3.17, 95% CI 1.27-7.93, P = 0.01) were independent risk factors for PD peritonitis.
  
  
  CONCLUSIONS
  Anxiety and depression were also common among Chinese PD patients. Those in HSG were more likely to develop PD peritonitis. These psychological symptoms deserved early detection. Further studies are needed to investigate whether intervention can improve the clinical outcome of these patients.
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Koon Ming
authors.initials: KM
authors.lastname: Chan
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Chi Yuen
authors.initials: CY
authors.lastname: Cheung
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Yiu Han
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Hoi Wong
authors.initials: HW
authors.lastname: Chan
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Wai Leung
authors.initials: WL
authors.lastname: Chak
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR.
authors.forename: Ka Foon
authors.initials: KF
authors.lastname: Chau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000523:psychology; D010538:Peritonitis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Anxiety; depression; peritoneal dialysis; peritonitis