Prevalence of psychiatric morbidity and its clinical correlates in patients of chronic kidney disease: A hospital-based cross-sectional study.

Abstract

Introduction: Psychiatric morbidity, particularly depression and anxiety, is a highly prevalent and critically important comorbidity in patients with Chronic Kidney Disease (CKD), with studies indicating that depression affects 20-30% of this population. This high prevalence is driven by a combination of physiological and psychosocial factors, including the burden of comorbid conditions like cardiovascular disease and diabetes, the debilitating symptoms of CKD itself, and the profound social and financial stresses associated with managing a chronic illness. The presence of these psychiatric conditions has serious consequences, leading to poorer adherence to treatment regimens, accelerated disease progression, increased hospitalization rates, and higher mortality. Aims:  To investigate the burden of psychiatric morbidity in patients with Chronic Kidney Disease and to propose a framework for integrated care. Setting and Design: A descriptive analytical cross-sectional Study. Methods and Material: This study was conducted at Pacific Medical College and Hospital, Udaipur from October 2022 to march 2024 (18 month). Result: In a study of 144 patients, socio-economic status distribution showed that the largest group was lower middle class, comprising 26.4% of the total, with 25% receiving conservative treatment and 27.8% undergoing dialysis. The middle class represented 23.6%, with 25% in the conservative group and 22.2% in the dialysis group. The lower class accounted for 22.2%, with 25% treated conservatively and 19.4% treated with dialysis. Upper middle-class patients made up 18.1%, with 16.7% in the conservative group and 19.4% in the dialysis group, duration of illness was categorized as follows: the majority (38.2%) had been ill for 1-5 years, with 41.7% in the conservative treatment group and 34.7% in the dialysis group. The next largest group (30.6%) had a duration of 6-10 years, with 27.8% of conservative patients and 33.3% of dialysis patients. Patients with an illness duration of more than 10 years represented 20.8%, with 19.4% in the conservative group and 22.2% in the dialysis group. Conclusion: our findings powerfully confirm and extend the existing body of evidence on the biopsychosocial model of CKD. The psychological morbidity in our cohort is severe, with depression and anxiety rates that are critically high. This distress manifests in impaired functioning and a disturbing prevalence of suicidal ideation. The comparative analysis with previous studies underscores that this is a universal challenge in nephrology care.

Keywords: Ckd, Psychiatric Comorbidity