3 results
Sleep quality and adherence to medical therapy among hemodialysis patients with depression: a cross-sectional study from a developing country
- Syed Muhammad Jawad Zaidi, Mehwish Kaneez, Javeria Awan, Hamza Waqar Bhatti, Muhammad Hamza, Mishal Fatima, Muhammad Zubair Satti
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S43
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Aims
Depression is a fairly common finding among end-stage renal disease (ESRD) patients on hemodialysis and is an independent risk factor for morbidity and mortality. The psychiatric manifestations of the disease may affect their compliance to medications and alter sleep quality that is often overlooked by nephrologists. This translates into poor quality of life and poorer disease prognosis. Thus, Our study aims to assess the prevalence of depression and its association with compliance to medical therapy and sleep quality among ESRD patients on hemodialysis.
MethodIn this cross-sectional study, a total of 288 hemodialysis patients with a confirmed diagnosis of ESRD were evaluated for depression using Patient Health Questionnaire-9 (PHQ-9) scale. Only the patients with moderate to severe depressive symptoms on PHQ-9 were further evaluated for sleep quality and compliance to medications using the Pittsburgh Sleep Quality Index (PSQI) and Drug Attitude Inventory-10 (DAI-10) respectively. The characteristics of ESRD patients with depression were also assessed. Median PHQ-9, DAI-10, and PSQI scores were calculated and the correlation between study variables was assessed using spearman's correlation.
ResultOf the 288 included participants, 188 (65.27%) had depression as evaluated via PHQ-9. Of these 188 patients, 114 were males while 74 were females. A total of 113 (60.01%) of the depressed patients had poor compliance with medication while 137 (72.87%) patients had poor sleep quality. Higher PHQ-9 scores were positively correlated with disease duration, dialysis years, and time between diagnosis and therapy (r = 0.41, 0.39, and 0.43 respectively) and negatively with marital and employment status (r = −0.32 and −0.49 respectively). Spearman's correlation matrix showed that PHQ-9 scores were negatively correlated with DAI-10 but positively correlated with PSQI scores.
ConclusionThe study indicates a high prevalence of depression among ESRD patients on hemodialysis. Poor sleep quality and non-adherence to medications are extremely common among ESRD patients with depression. These psychiatric components must be considered to optimize medical treatment and improve the quality of life in this subset of patients.
Attitudes of medical students towards psychiatry and mental illnesses: a cross-sectional study from Pakistan
- Mishal Fatima, Raja Adnan Ahmed, Muhammad Hamza, Syed Muhammad Jawad Zaidi, Hassan Nadeem, Mehwish Kaneez
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, pp. S303-S304
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Aims
The increasing burden of mental disorders coupled with the social stigmatization in Pakistan is an immense barrier in combating the emerging mental health crisis. The low number of qualified psychiatrists and poor intake in post-graduate psychiatry training programs in the region further complicates the problem. Thus, our study aims to assess the attitudes of Pakistani medical students towards psychiatry. Furthermore, we also aim to evaluate how experience and different levels of exposure to psychiatry among students affect their attitudes towards psychiatry as a career choice.
MethodThis cross-sectional study was conducted via an online survey made on Google Forms. A total of 831 medical students studying across various private and public medical institutions of Pakistan responded to the survey. The questionnaire comprised of demographical details (gender, age, institution, and academic year) exposure to psychiatry, duration of psychiatry rotation, and personal experience with mental illness. The attitudes of medical students towards psychiatry were evaluated using the English version of the 30-item Attitudes Towards Psychiatry (ATP-30) scale. Chi-square test and multiple regression with backward method were used to analyze the data.
ResultThe Cronbach's alpha value of the ATP-30 scale was 0.830. The participants in our study had a mean score of 107.6 ± 12 on ATP-30. Overall, most participants had a positive attitude towards psychiatry. Multiple regression analysis revealed a significant model pertaining to predictors of attitude toward psychiatry (F (df) = 11.28 (830), P < 0.001). However, the predictors included in the model accounted for only 5.8% of the variation in ATP-30 scores. According to it, those students had a more positive attitude toward psychiatry who identified as female, older and having any sort of exposure toward psychiatric specialty, direct involvement in psychiatric patient care, and reporting personal experience of mental illnesses.
ConclusionOur study showed that medical students had a positive attitude towards psychiatry but female medical students, students with previous exposure to psychiatry, and students with longer psychiatry rotations tend to view psychiatry more positively. The generally positive trend towards psychiatry in Pakistan indicates the need to sustain improvements through proactive measures. We recommend longer placements for medical students in mental health settings for at least 4 weeks or longer. Medical schools should also promote research, discussions, and seminars on different psychiatric illnesses in order to enhance awareness among the students.
Exploring the predictive factors for depression among hemodialysis patients: a case-control study
- Syed Muhammad Jawad Zaidi, Mehwish Kaneez, Hamza Waqar Bhatti, Shanzeh Khan, Shafaq Fatima, Muhammad Hamza, Mishal Fatima
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, pp. S43-S44
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- Article
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- You have access Access
- Open access
- Export citation
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Aims
Depression remains an exceedingly ubiquitous entity that significantly depreciates the quality of life and disease prognosis among end-stage renal disease (ESRD) patients. Even though the deleterious effects of depression on ESRD patients are well-established in the literature, the predictive factors that predispose such patients to depression need to be explored. Our study thus aims to gauge these factors and create a predictive model for optimal psychiatric and medical management of such patients.
MethodAll ESRD patients with a disease duration of at least one year underwent a complete psychiatric evaluation based on DSM-V guidelines preceded by a cognitive evaluation by Mini-Mental State Examination (MMSE). A total of 73 patients diagnosed with moderate to severe major depressive disorder were selected as cases. Patients suffering from recurrent psychotic episodes, having a past or family history of psychiatric illness, being already treated for depression, having any substance abuse (current or past), were excluded from the study. Following the similar guidelines, and exclusion criteria, 146 patients (two controls for each case) having no depression were selected as controls. The cases and controls were studied and matched for a myriad of sociodemographic factors. The various risk factors for depression were evaluated using univariate and multivariate binary logistics analysis.
ResultThe significant risk factors for depression among hemodialysis patients were age (OR = 1.79, CI = 0.47–3.81), comorbidities (OR = 2.13, CI = 0.51–3.96), duration of renal disease (OR = 2.54, CI 0.63–4.28), duration of hemodialysis (OR = 2.36, CI = 0.89–4.11), unemployment (OR = 2.33, CI = 0.79–3.88), and being unmarried (OR = 1.93, CI = 0.44–3.53). Prospect of survival, financial instability, social stigmatization, and effect of comorbidities on ESRD were major concerns for the cases that attributed to their depressive symptoms.
ConclusionThe factors that herald the onset of depression among hemodialysis patients include increasing age, presence of comorbidities, unemployment being unmarried, and increasing duration of hemodialysis. These factors will aid the clinicians to identify high-risk patients that require psychiatric consultation. We recommend prompt psychiatric intervention (pharmacologic or non-pharmacologic) and appropriate patient counseling so that the depressive symptoms can be alleviated and dismal disease prognosis can be prevented among such high-risk patients.