The Variable Course of Emotional Distress Over Time in Patients on HEMODIALYIS. the Role of Social Support Indicators

Abstract

BACKGROUND: Depression is common in hemodialysis patients but little is known about the course of distress over time. This study set up to map the course of anxiety and depression and to identify factors associated with different trajectories. METHODS: 159 hemodialysis patients completed the HADS and measures of social support on two occasions 12 months apart. Clinical cut-offs were used to identify patterns of change and general linear models were applied to identify correlates of these trajectories. FINDINGS: Mean anxiety and depression remained unchanged with over 50% above cut-offs. While most patients had either persistent symptoms (39.6% depression; 31.8% Anxiety) or no/low symptoms (32.1% depression; 36.9% anxiety), 12.7% to 14.5% either had new-onset or recovered. Patients with persisting or new-onset symptoms of distress reported worsening in social support and quality of social interaction compared to patients with no/low symptoms (p<.01). DISCUSSION: Different patterns of symptoms reflect heterogeneity in patients’ emotional adjustment. More research is needed to identify patients at risk for emotional distress and to explore social support in the context of dialysis