Influence Of Depression, Anxiety And Stress On The Quality Of Life Of Dialysis

PatientsAssoc Prof Dr Ramli Musa

International Islamic University Malaysia

Prevalence of Psychiatric Disorders? QOL and its relationships? How good of the psychological tools?

Background: Renal failure patients

1. Depression; The most common psychiatric complication

(33.4% - Chen et al. Nephrology (Carlton). 2003 Jun;8(3):121-6.

2. Suicidal Behavior3. Delirium; uremia, anemia,

hyperparathyroidism, dialysis disequilibrium syndrome.

4. Anxiety and Panic Symptoms

Psychiatric morbidities

Nature of the illness; chronic cost of dialysis therapy many other medical conditions

Why psychiatric morbidities are high?

Fund; MOSTI Malaysia

1. DASS-21- Depression Anxiety and Stress Scale2. WHOQOL-BREF- World Health Organization Quality of

Life -- validated, Malay, Chinese and English versions.

Stratified random sampling The Malaysian National Renal Registry 25, 763 haemodialysis (HD) and continuous

ambulatory peritoneal dialysis (CAPD)

1569 subjects ---- > 1,333 patients

Method of the study:

23 government, NGO and private hospitals.

Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM).

Results:

(inclusive of mild, moderate, severeor extremely severe)

1, 333

Depression 26% (347 pts)

Anxiety 47% (626 pts)

Stress 22% (293 pts)

10

Depression Anxiety Stress

Psychosocial Distress

Quality of Life

Environment Physical Health Psychological

Health

Chi-square = 4.604df = 292P = .000CFI = .918GFI = .912RMR = .037RMSEA = .055

.82

Depression

.57

d21

e1

.75

.56

d17

e2

.75

.56

d10

e3

.75

.37

d5

e4

.61

.40

d3

e5

.63

1.00

Stress

.40d18 e6

.63.59

d11 e7.77

.37

d8 e8.61

.42d6 e9

.65

.96

Anxiety

.51 d20e10

.71

.46 d9e11 .68

.33d7e12

.57

.34d4e13

.58

.58

PhysicalHealth

.43

qol10

e14

.66

.49

qol15

e15

.70

.34

qol16

e16

.58

.71

qol17

e17

.57

qol18

e18

.75

.92

Environment

.27qol23 e19

.52.39

qol13 e20.62

.33qol12 e21

.57

.48qol8 e22

.69

.84

PsychologicalHealth

.37qol9e23

.60.49

qol7e24 .70

.57qol6e25

.75

.54qol5e26

.73

.26

QOL

.00

PsychologicalDistress

e27

e28e29

e30e31

e32

e33

e34

.76

-.51

.84

1.00.98

.96.92

.91

Depression

Stress

.42d6 e1.65

.38d8 e2

.62

.59

d11 e3.77

.39d18 e4

.63

Anxiety

.34d4 e5

.33

d7 e6

.46d9 e7

.50d20 e8

.58

.58

.68

.71

.94

.91

1.00

Chi-square = 5.332df = 41P = .000CFI = .964GFI = .966RMR = .019RMSEA = .060

.42d3 e9.65

.53d10 e10

.73

.49d17 e11

.70

Psychiatric morbidities are high QOL is related to level of depression DASS 21 and WHOQOl BREF are good tools

Conclusion:

Thank youramlidr@yahoo.com