Psychiatric disorders, body mass index and C-reactive protein in dialysis patients

• Published in: General hospital psychiatry 2011-09, Vol.33 (5), p.454-461
• Main Authors: Preljevic, Valjbona Tiric, M.D, Østhus, Tone Brit Hortemo, M.D, Sandvik, Leiv, Ph.D, Bringager, Christine Bull, M.D., Ph.D, Opjordsmoen, Stein, M.D., Ph.D, Nordhus, Inger Hilde, Ph.D, Os, Ingrid, M.D., Ph.D, Dammen, Toril, M.D., Ph.D
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Anxiety; Biological and medical sciences; Body Mass Index; C-Reactive Protein - analysis; Comorbidity; Depression; Dialysis; Female; Humans; Logistic Models; Male; Malnutrition - complications; Malnutrition - epidemiology; Malnutrition - psychology; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Middle Aged; Miscellaneous; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Norway - epidemiology; Prevalence; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; Renal Dialysis - psychology; Renal failure; Risk Factors; Somatoform disorders
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2011.06.010

Abstract Objective The objective of the study was to identify the prevalence of depression, anxiety and somatoform disorders in dialysis patients according to dialysis modality and to compare dialysis patients with and without psychiatric comorbidity regarding clinical characteristics, health-related quality of life (HRQoL) and markers of nutrition and inflammation. Methods One hundred and nine patients were assessed for depression, anxiety and somatoform disorder with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . The Short Form 36 was used. Sociodemographic, clinical and laboratory data were collected. Results About one third, 30.3%, had a current psychiatric disorder regardless of dialysis modality (depression, 22%; anxiety, 17%; somatoform disorders, 1%), and these reported more impairment on HRQoL dimensions. In the multivariate analysis, significant correlations between psychiatric comorbidity and C-reactive protein (CRP≥6 mmol/L) [odds ratio (OR), 3.6; 95% confidence interval (CI), 1.3–9.9; P =.015] and body mass index (BMI≤21 kg/m2 ) (OR, 4.2; 95% CI, 1.4–12.7; P =.011) were observed. Conclusion Depressive and anxiety disorders were common in dialysis patients and were associated with impaired HRQoL, while prevalence of somatoform disorders was low. A strong correlation between psychiatric comorbidity, CRP and BMI indicates that special attention should be given to patients with CRP≥6 mmol/L and BMI≤21 kg/m2.