Posttraumatic Embitterment Disorder in Patients with Chronic Kidney Disease
10.9758/cpn.2019.17.2.183
- Author:
Kyungsoo LEE
1
;
Ho Chul SONG
;
Euy Jin CHOI
;
Chi Un PAE
;
Yong Kyun KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. drkimyk@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Posttraumatic embitterment disorder;
Dialysis;
Depression;
Quality of life;
Chronic renal insufficiency
- MeSH:
Adjustment Disorders;
Anger;
Depression;
Diabetes Mellitus;
Diagnosis;
Dialysis;
Glomerular Filtration Rate;
Humans;
Logistic Models;
Multivariate Analysis;
Prevalence;
Quality of Life;
Renal Dialysis;
Renal Insufficiency, Chronic
- From:Clinical Psychopharmacology and Neuroscience
2019;17(2):183-188
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Posttraumatic embitterment disorder (PTED), a subgroup of an adjustment disorder, is a feeling with anger and helplessness. Hemodialysis may be a trigger event leading to PTED. We investigated the prevalence of PTED in patients with each categorized stages of chronic kidney disease (CKD) and the association between PTED and depression and functional impairment. METHODS: Patients were categorized into three groups according to the stages of CKD (stage I–II, III–IV, and V). CKD (I–II) group was defined as estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m², CKD (III–IV) group as eGFR <60 ml/min/1.73 m², and CKD (V) group as CKD stage V including patients ongoing hemodialysis. Patients were assessed for the prevalence of PTED, depression, and decreased quality of life by using the scale of PTED, Patient Health Questionnaire-9 (PHQ-9), and EuroQol Five Dimensional Questionnaires, Visual Analogue Scale (EQ-5D-VAS), respectively. RESULTS: A total of 445 patients were analyzed. The number of patients in CKD (I–II) was 166, CKD (III–IV) was 172, and CKD (V) was 107. Multivariate analysis by binomial logistic regression demonstrated that CKD (V) was significantly associated with the prevalence of PTED (odds ratio, 4.13; 95% confidence interval, 1.56–15.6; p=0.006) after adjustment for age, gender, and diabetes mellitus. Also, a significant correlation existed between PTED and EQ-5D-VAS in all stages, but the correlation was nonsignificant between PTED and PHQ-9 score in group CKD (V). CONCLUSION: The findings suggest that PTED is underdiagnosed in CKD patients. Acknowledgment and diagnosis of PTED in CKD patients may lead to a better quality of life.
