The role of socio-demographic factors in depression and anxiety of patients on hemodialysis: an observational cross-sectional study
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Depression and anxiety have high prevalence in patients on hemodialysis and are strongly associated with socio-economic factors. The aim of this study was to evaluate the prevalence of depression and anxiety in hemodialyzed patients in Greece and its association with socio-demographic factors.
Four hundred and fourteen (414) patients on hemodialysis (262 males and 152 females) from 24 dialysis centers in Greece participated in this observational cross-sectional study. Mean age was 63.54 (54.06–72.41), and mean time of dialysis treatment was 36 (16–72) months. Depression and anxiety were assessed by the state–trait anxiety inventory (STAI), the beck depression inventory (BDI) and the hospital anxiety and depression scale (HADS). Multinomial logistic regression was performed to estimate the factors being independently associated with anxiety and depression levels (HADS scale). Multiple linear regression was performed to estimate the factors being independently associated with BDI and STAI.
From a total of 414 participants, (29.4%, n = 122) had depression and 35.9% (n = 149) had anxiety. Depression and anxiety were significantly associated with females, low level of education, increased patients’ age, retirement, poor financial situation, marital status and co-morbidities.
The overall study findings indicated a significant correlation between the levels of anxiety and depression in patients on hemodialysis. Patients with high levels of anxiety had higher levels of depression and those with high depression scores had higher anxiety scores.
KeywordsAnxiety Depression Hemodialysis Kidney failure Socio-demographic factors
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest in publishing this research article.
This study was conducted under the approval of the Ethics Committee of National and Kapodistrian University of Athens, Department of Medicine, ‘Aretaieio’ Hospital.
- 1.Wang L, Chen C (2012) The psychological impact of hemodialysis on patients with chronic renal failure. In: Polenakovic M (ed) InTech. http://www.intechopen.com/books/renal-failure-the-facts/the-psychological-impact-ofhemodialysis-on-patients-with-chronic-renal-failure (ISBN: 978-953-51-0630-2)
- 5.Gerogianni S, Babatsikou F, Gerogianni G, Grapsa E, Vasilopoulos G, Zyga S, Koutis C (2014) Concerns of patients on dialysis: a research study. Health Sci J 8(4):423–437Google Scholar
- 6.Feroze U, Martin D, Reina-Patton A, Kalantar-Zadeh K, Kopple J (2010) Mental health depression and anxiety in patients on maintenance dialysis. Iranian J Kidney Dis 4(3):173–180Google Scholar
- 7.Dijk S, Beukel T, Kaptein A, Honig A, Cessie S, Siegert C, Boeschoten E, Krediet R, Dekker F (2013) How baseline new-onset and persistent depressive symptoms are associated with cardiovascular and non-cardiovascular mortality in incident patients on chronic dialysis. J Psychosom Res 74:511–517. https://doi.org/10.1016/j.jpsychores.2013.03.001 CrossRefPubMedGoogle Scholar
- 11.Gerogianni G, Babatsikou F (2013) Identification of stress in chronic haemodialysis. Health Sci J 7(2):169–176Google Scholar
- 14.Lilympaki I, Makri A, Vlantousi K, Koutelekos I, Babatsikou F, Polikandrioti M (2016) Effect of perceived social support on the levels of anxiety and depression of hemodialysis patients. Mater Sociomed 28(5):361–365. https://doi.org/10.5455/msm.2016.28.361-365 CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Vieco M, García R, Albalate M, Sequera P, Ortega M, Puerta M, Corchete E, Alcázar R (2014) Psychosocial factors and adherence to drug treatment in patients on chronic haemodialysis. Nefrologia 34(6):737–742. https://doi.org/10.3265/Nefrologia.pre2014.Jul.12477 Google Scholar
- 16.McKercher C, Venn A, Blizzard L, Nelson M, Palmer A, Ashby M, Scott J, Jose M (2013) Psychosocial factors in adults with chronic kidney disease: characteristics of pilot participants in the tasmanian chronic kidney disease study. BMC Nephrol 14(83):1–9Google Scholar
- 17.Zigmond A, Snaith R (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x CrossRefPubMedGoogle Scholar
- 20.Spielberger C (1970) Manual for the state–trait anxiety inventory (self-evaluation questionnaire). CA Consulting Psychologists press, Palo AltoGoogle Scholar
- 21.Fountoulakis K, Papadopoulou M, Kleanthous S, Papadopoulou A, Bizeli V, Nimatoudis I, Iacovides A, Kaprinis G (2006) Reliability and psychometric properties of the Greek translation of the state–trait anxiety inventory form Y: preliminary data. Ann Gen Psychiatry 5(2):1–10. https://doi.org/10.1186/1744-859X-5-2 Google Scholar
- 24.Jemos J (1984) Beck depression inventory: validation in a Greek sample. University Medical School Athens, AthensGoogle Scholar
- 28.Mystakidou K, Tsilika E, Parpa E, Smyrniotis V, Galanos A (2007) Beck depression inventory: exploring its psychometric properties in a palliative care population of advanced cancer patients. Eur J Cancer Care (Engl) 16(3):244–250. https://doi.org/10.1111/j.1365-2354.2006.00728.x CrossRefGoogle Scholar
- 29.Michopoulos I, Kalkavoura C, Michalopoulou P, Fineti K, Kalemi G, Psarra M, Gournellis R, Christodoulou C, Douzenis A, Patapis P, Protopapas K, Lykouras L (2007) Hospital anxiety and depression scale (HADS): validation in a Greek general hospital sample. Psychiatriki 18(3):217–224PubMedGoogle Scholar
- 30.Armaly Z, Farah J, Jabbour A, Bisharat B, Qader A, Saba S, Zaher M, Haj E, Hamzi M, Bowirrat A (2012) Major depressive disorders in chronic hemodialysis patients in Nazareth: identification and assessment. Neuropsychiatr Dis Treat 8:329–338. https://doi.org/10.2147/NDT.S31903 PubMedPubMedCentralGoogle Scholar
- 31.Carayanni V, Stylianopoulou C, Koulierakis G, Babatsikou F, Koutis C (2012) Sex differences in depression among older adults: are older women more vulnerable than men in social risk factors? The case of open care centers for older people in Greece. Eur J Ageing 9:177–186. https://doi.org/10.1007/s10433-012-0216-x CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Gerogianni S, Babatsikou F, Gerogianni G, Koutis C, Panagiotou M, Psimenou E (2016) Social life of patients undergoing haemodialysis. Int J Caring Sci 9:122–134Google Scholar
- 37.Imanishi Y, Fukuma S, Karaboyas A, Robinson B, Pisoni R, Nomura T, Akiba T, Akizawa T, Kurokawa K, Saito A, Fukuhara S, Inaba M (2017) Associations of employment status and educational levels with mortality and hospitalization in the dialysis outcomes and practice patterns study in Japan. PLoS ONE 12(3):1–11. https://doi.org/10.1371/journal.pone.0170731 CrossRefGoogle Scholar
- 41.Angouria A, Alexiadou A, Diamanti M, Vasilopoulou C, Bourtsi E, Polikandrioti M (2015) Anxiety and depression in patients on hemodialysis. Arch Hellenic Med 32(3):328–339Google Scholar
- 43.Stankovic J, Stojimirović B, Bukumirić Z, Hadžibulić E, Andrić B, Djordjević V, Marjanović Z, Birdjozlić F, Nešić D, Jovanović D (2014) Depression and quality of sleep in maintenance hemodialysis patients. Srp Arh Celok Lek 142(7–8):437–443. https://doi.org/10.2298/SARH1408437T CrossRefGoogle Scholar
- 52.Radwan D, Sany D, Elmissiry A, Shahawy Y, Fekry W (2013) Screening for depression and associated risk factors among Egyptian end-stage renal disease patients on haemodialysis. Middle East Curr Psychiatry 20:183–190. https://doi.org/10.1097/01.XME.0000433782.59658.a3 CrossRefGoogle Scholar
- 53.Gerogianni S, Babatsikou F (2014) Social aspects of chronic renal failure in patients undergoing haemodialysis. Int J Caring Sci 7(3):740–745Google Scholar