Analysis of the prevalence and influencing factors of depression and anxiety among maintenance dialysis patients during the COVID-19 pandemic

Abstract

Objective: Currently, the COVID-19 outbreak and its spread around the globe is significantly affecting mental health and health in general, worldwide. During the COVID-19 pandemic, the general medical complications have received the most attention, whereas only a few studies address the potential direct impact of SARS-CoV-2 on mental health.

Methods: A total of 321 maintenance hemodialysis (MHD) patients were selected using random sampling from the hemodialysis center of the second people's Hospital of Yibin. They completed Zung's self-rating anxiety scale (SAS) for anxiety, Zung's self-rating depression scale (SDS) for depression, and the activity of daily living scale (ADL) for the ability of living. Demographic data and laboratory tests were used to analyze the risk factors.

Results: The proportions of the prevalence of anxiety and depression symptoms were between 34.89% and 30.02%, respectively, among the MHD patients. The SAS and SDS scores of the 321 patients were 45.42(± 10.99) and 45.23(± 11.59), respectively. The results show that monthly income, medical insurance, vascular access, the duration of dialysis, complication, hemoglobin (HGB), immunoreactive parathyroid hormone (iPTH) and blood phosphorus (P) are factors that influence anxiety among patients (p < 0.05 for all). Vascular access, monthly income, medical insurance, complication, CRP, Alb, are factors that influence depression among patients (p < 0.05 for all).

Conclusion: Our results suggest that during the pandemic period, the prevalence of anxiety and depression symptoms among MHD patients increased. Some demographic and clinical variables were associated with it. We should, therefore, pay more attention to the patients' psychology, start targeted intervention to alleviate the patients' anxiety and further improve their quality of life.

Keywords: Anxiety; COVID-19; Depression; Logistic models; Maintenance hemodialysis.

Fig. 1

Single-factor analysis of anxiety among MHD patients with different demographic characteristics (N = 321)

Fig. 2

Single-factor analysis of depression among MHD patients with different demographic characteristics (N = 321)

Fig. 3

Single-factor analysis of anxiety among MHD patients with laboratory tests (N = 321)

Fig. 4

Single-factor analysis of depression among MHD patients with laboratory tests (N = 321). SD standard deviation, SDS Zung’s self-rating depression scale, SAS Zung’s self-rating anxiety scale. Normal value range of each index: HGB (men 131–172, women 113–151), iPTH 12–88, P 0.8–1.45, Alb 40–55, CRP 0.00–10 mg/L, β2-MG 0.8–2.4, RDW-SD 35–56

Fig. 5

Logistic analysis of anxiety symptoms among MHD patients (N = 321)

Fig. 6

Logistic analysis of depression symptoms among MHD patients (N = 321)