The Journal of the Association of Physicians of India · 2026
Study of Depression, Anxiety, Somatic Symptoms, and Quality of Life in Patients with Chronic Kidney Disease on Maintenance Hemodialysis in a Tertiary Hospital in Chennai.
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Subramaniam Suresh Kanna, Rao Vinjamuri Ramachandra
Аннотация
BACKGROUND: Chronic kidney disease (CKD) is associated with substantial psychological morbidity, particularly among patients receiving maintenance hemodialysis (MHD). Depression, anxiety, and somatic symptoms adversely affect health-related quality of life (HRQoL), yet these factors remain under-recognized in routine clinical practice.
OBJECTIVES: To assess the prevalence and severity of depression, anxiety, and somatic symptoms and to evaluate their association with quality of life among patients with CKD undergoing maintenance hemodialysis.
MATERIALS AND METHODS: This hospital-based cross-sectional observational study included 50 adult patients with CKD receiving maintenance hemodialysis at a tertiary care hospital in Chennai. Participants were assessed using the Hospital Anxiety and Depression scale (HADS), Somatic Symptom scale-8 (SSS-8), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Data were analyzed using R software. Categorical variables were compared using the Chi-square test, and a p-value < 0.05 was considered statistically significant.
RESULTS: Psychological distress and somatic symptom burden were common among patients undergoing maintenance hemodialysis. Female participants demonstrated a higher prevalence of abnormal depression scores, whereas abnormal anxiety scores were more frequent among males; however, these differences were not statistically significant (anxiety: p = 0.053; depression: p = 0.170). No significant associations were observed between age, CKD stage, or overall quality-of-life quartiles and HADS anxiety or depression scores (p > 0.05). A highly significant association was observed between SSS-8 quartiles and somatic symptom severity (p < 0.0001), indicating that higher somatic symptom scores were associated with greater symptom burden.
CONCLUSION: Depression, anxiety, and somatic symptoms are common among patients with CKD receiving maintenance hemodialysis. Although most demographic and clinical variables were not significantly associated with psychological distress, greater somatic symptom burden was strongly associated with higher SSS-8 scores. Routine psychological assessment using validated screening tools may facilitate early identification and comprehensive management of psychological morbidity in patients undergoing maintenance hemodialysis.
OBJECTIVES: To assess the prevalence and severity of depression, anxiety, and somatic symptoms and to evaluate their association with quality of life among patients with CKD undergoing maintenance hemodialysis.
MATERIALS AND METHODS: This hospital-based cross-sectional observational study included 50 adult patients with CKD receiving maintenance hemodialysis at a tertiary care hospital in Chennai. Participants were assessed using the Hospital Anxiety and Depression scale (HADS), Somatic Symptom scale-8 (SSS-8), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Data were analyzed using R software. Categorical variables were compared using the Chi-square test, and a p-value < 0.05 was considered statistically significant.
RESULTS: Psychological distress and somatic symptom burden were common among patients undergoing maintenance hemodialysis. Female participants demonstrated a higher prevalence of abnormal depression scores, whereas abnormal anxiety scores were more frequent among males; however, these differences were not statistically significant (anxiety: p = 0.053; depression: p = 0.170). No significant associations were observed between age, CKD stage, or overall quality-of-life quartiles and HADS anxiety or depression scores (p > 0.05). A highly significant association was observed between SSS-8 quartiles and somatic symptom severity (p < 0.0001), indicating that higher somatic symptom scores were associated with greater symptom burden.
CONCLUSION: Depression, anxiety, and somatic symptoms are common among patients with CKD receiving maintenance hemodialysis. Although most demographic and clinical variables were not significantly associated with psychological distress, greater somatic symptom burden was strongly associated with higher SSS-8 scores. Routine psychological assessment using validated screening tools may facilitate early identification and comprehensive management of psychological morbidity in patients undergoing maintenance hemodialysis.