Evaluation of psychological profile and quality of life of dialysis patents in Malaysia

Introduction: The existence of multiple psychiatric comorbid illnesses is an important public health problem in dialysis population. Depression has long been identified as the primary mental health problem of end stage renal disease in other countries (ESRD). According to the 18th report of the Malaysian Dialysis & Renal Transplant Registry 2010, there were 23403 haemodialysis (HD) and 2360 continuous ambulatory peritoneal dialysis (CAPD) patients. The extent of psycho-pathology in dialysis population and its impact on quality of life (QOL) is largely unknown. Primary objectives: To determine the prevalence of depression, anxiety and stress among dialysis patients To measure the QOL of dialysis patients in Malaysia. To analyze the association between psychological profiles and QOL. Secondary objectives: To identify significant demographic determinants to their psychological profile and QOL To compare psychological profiles and QOL with different modality of renal replacement therapy (HD versus CAPD) Method: After informed consent, patients were administered two survey forms: i. Depressive Anxiety and Stress Scales (DASS21) ii. WHOQOL-BREF. Demographic form ; age, gender, ethnic group, religion, level of education, employment status, family income, financial aid for dialysis and erythropoietin injections, modality of dialysis and medical and psychiatric history. Inclusion Criteria: Those who can communicate in BM, English or Chinese Exclusion criteria: Patients who are having organic brain disorders such as dementia or delirium Study population: A total of 15 HD centres and 6 CAPD centres involved in this study with target study population of 1470 patients. Stratified sampling was used to select the hospitals or dialysis centres. From 1312 subjects, 317 subject (24.2%) were depressed, 475 subjects (36.1%), and 154 subjects (11.7%) were having anxiety. There is strong negative correlation between QOL and DASS (r2= - 0.52). Which means those with high level of depression, anxiety and stress would have poor quality of life. Depression is related to poor financial support, poor family support, females and low education (p