Prevalence of Psychiatric Morbidity and its Clinical Correlates in Patients of Chronic Kidney Disease: A Hospital Based Cross Sectional Study

Title of the Project “Prevalence of psychiatric morbidity and its clinical correlates in in patients of chronic kidney diseaseâ€

A. Expected outcome & Application: We anticipate that kidney function disease patients may exhibit a wide range of psychiatric symptoms secondary to their illness and treatment-related experiences. The severity of depression and anxiety is particularly expected to be higher in patients with chronic and disabling symptoms, based on their socio-demographic and clinical profiles.

CKD patients are undergoing tremendous physical, psychological, emotional and financial stress of high order. This may lead to negative outlook in these patients, because of dependency and disability. Psychiatric comorbidity in CKD is an important factor in determining the treatment outcome as it is associated with poor adherence. So it becomes important to evaluate the prevalence and severity of psychiatric disorders in people with CKD. Proper identification and treatment of psychiatric comorbidity will help improve treatment adherence, quality of life and illness outcome.

Research question:

Ø  What is the prevalence of various psychiatric morbidities in CKD patients?

Ø  What is the impact of individual patient variables on these psychiatric morbidities?

. Aims and objectives:

To estimate the prevalence of psychiatric morbidity in patients with chronic kidney disease

To study the nature and severity of psychiatric manifestations in patients with CKD, on conservative treatment, on hemodialysis

To study the role of support systems, functional level, treatment adherence in relation to psychiatric illness.

Selection criteria for participants:

A. Inclusion criteria:

Patients of both genders who are between 18 to 60 years of age.

Patients who are willing to give their consent for the study.

Exclusion criteria:

Patient diagnosed to have mental illness prior to the onset of CKD

Refused to give consent to study

. Sampling:

 A. Population: CancerPatients coming to NEPHROLOGY OPD/IPD at PMCH.

 B. Sampling method: Convenient sampling

  C. Sample size: 144 (72) each group)

·       INSTRUMENTS OF THE STUDY:

The following instruments will be applied on all study subjects:

A. MINI INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW (MINI):

B. KPS ( Karnofsky performance status)

C. BDI ( Becks depression inventory)

D. BAI ( Becks Anxiety inventory)

Ø  MINI INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW (MINI): MINI is designed as a brief diagnostic interview to meet the need for short but accurate structured psychiatric interview for multicentre clinical trials and epidemiological studies. It acts as a first step in outcome tracking in non-research clinical settings. It assesses the 17 most common disorders in mental health.

Ø  KPS: The Karnofsky Performance Scale Index is an assessment tool forfunctional impairment. It can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. In most serious illnesses, the lower the Karnofsky score, the worse the likelihood of survival

Ø  BDI: The Beck Depression Inventory (BDI) is widely used toscreen for depression and to measure behavioural manifestations and severity of depression BDI cut-off scores to be used with affective disorder patients: scores from 0 through 9 indicate no or minimal depression; scores from 10 through 18 indicate mild to moderate depression; scores from 19 through 29 indicate moderate to severe depression; and scores from 30 through 63 indicate severe depression.

Ø  BAI**:** Beck Anxiety Inventory is a well accepted self-report screening measure of the severity of anxiety in adults and adolescents for use in both clinical and research settings. Total score (0–63), where Minimal Level of Anxiety (0–7); Mild Anxiety (8–15); Moderate Anxiety (16–25); Severe Anxiety (26–63)