[Anxiety disorders in dialysis patients].

BACKGROUND

Anxiety, as a primary symptom, includes all conditions of indefinite fear and psychic disorders dominated by fear. All dialysis patients suffer from anxiety as an independent phenomenon, or as part of another disease.

METHODS

This study included 753 patients on chronic hemodialysis in Bosnia and Herzegovina (B&H) in the period 1999-2004. The patients were divided into two groups: the first group included 348 patients with Balkan Endemic Nephropathy (BEN), and the control group included 405 patients with other diagnoses causing renal insufficiency (N18). The study was designed as a comparative cross sectional study, and patients were tested using questionnaires assessing anxiety, depression and general mental health status. Statistical analysis was done using standard descriptive and analytical methods.

RESULTS

Socio-demographic data showed highly significant differences between BEN and N18 in relation to place of residence (urban/rural) (chi2 = 23.970) p < 0.01: in the incidence of renal comorbidity (chi2 = 23.970) p < 0.01, familial renal comorbidity (chi2 = 23.970) p < 0.01 and mnigrations (chi2 = 4.874) p < 0.01. Beck Anxiety Inventory Scores were highly significantly different between the two groups p < 0.001, in regard to the incidence and variables. Hamilton Depression Rating Scale demonstrated a group significance p < 0.001, and variables pointed to somatization, general anxiety and depression. This was confirmed by mini-mental state examnination pointing to general mental weakness.

CONCLUSIONS

Anxiety appeared in all tested dialysis patients. It may be independent, somatized as part of another mental disorder or reinforced by a cognitive damage. Structured anxiety and depression result in pre-suicidal risk.