Prevalence and determinants of anxiety and depression in end stage renal disease (ESRD). A comparison between ESRD patients with and without coexisting diabetes mellitus.
To compare anxiety and/or depressive symptoms between patients with end-stage renal disease with and without comorbid diabetes and identify factors associated with symptoms of distress in this population.



Data from two studies (conducted between 2010 and 2014) were pooled. A total of 526 patients on hemodialysis (68.8% with diabetes) completed the Hospital Anxiety and Depression Scale (HADS). Elevated symptoms were defined as HADS-Anxiety or HADS-Depression≥8. Univariate and multivariate logistic regressions were used to estimate associations between diabetic status, and other socio-demographic and clinical factors with baseline clinical anxiety and depression.



A total of 233 (45.4%) reported elevated anxiety symptoms and 256 (49.9%) reported elevated depressive symptoms sufficient for caseness. Rates were not different between patients with and without diabetes. Risk for clinical depression was higher in patients who were single/unpartnered (OR=1.828), Chinese vs. Malay (OR=2.05), or had lower albumin levels (OR=0.932). None of the parameters were associated with anxiety caseness.



Sociocultural factors rather than comorbid burden may help identify patients at risk for depression. The high rates of anxiety and depression underlie the importance for monitoring and intervention in dialysis care.
Department of Psychology, National University of Singapore, Singapore.
Russell Kl
RK
Yoong
National Kidney Foundation Singapore, Singapore.
Nandakumar
N
Mooppil
Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore; Division of Endocrinology, University Medicine Cluster, National University Health System, Singapore.
Eric Yh
EY
Khoo
City University London, London, UK.
Stanton P
SP
Newman
Department of Psychology, National University of Singapore, Singapore.
Vanessa Yw
VY
Lee
Department of Psychology, National University of Singapore, Singapore.
Augustine Wc
AW
Kang
Department of Psychology, National University of Singapore, Singapore. Electronic address: psygk@nus.edu.sg.
Konstadina
K
Griva
D001007:Anxiety / Q000150:complications* / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D048909:Diabetes Complications / Q000150:complications / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis
Anxiety; Depression; Diabetes mellitus; End-stage renal disease