Objective To investigate the incidence of depression and anxiety and their related factors in continuous ambulatory peritoneal dialysis (CAPD) patients, and to evaluate the correlation of depression and anxiety with Engle coefficient, treatment compliance, complication, and nutrition status in these patients. Methods Seventy-five outpatients with end-stage renal disease and treated with CAPD were recruited in this cross-sectional study. Their demographic data and primary disease were collected. Patient's family income was assessed by Engle coefficient. Anxiety and depression were rated by the Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA). Residual renal function was evaluated by creatinine clearance calculated by the MDRD equation. Nutrition status was measured by the subjective global assessment (SGA) in combination with blood biochemical indices. We also estimated tbeir complications by Charlson coefficient, and their activities by EOCG/Karnofsky activity indices. Results In the 75 outpatients recruited from this dialysis center, 28 cases (37.33%) were identified as having depression and/or anxiety symptoms. The occurrence of depression and anxiety symptoms related to the disease status and income level (P < 0.05). CAPD patients with depression or anxiety had less activities, poor compliance, more complications, and higher malnutrition rate. Psychological symptoms correlated negatively with hemoglobin, serum albumin, urea nitrogen and Kt/V (P < 0.01), and positively with nutritional status (P < 0.01). On the other hand, psychological problems significantly affected nutritional status (OR= 3.610, P< 0.05). Conclusions In uremic patients on CAPD, depressive and anxious symptoms were frequently encountered. Most CAPD patients with psycho-logical symptoms were associated with malnutrition, poor compliance or other complications. Moreover, psychological symptoms induced the presence of malnutrition. Psychological symptoms related not only to the primary disease and its complications, but also to patient's income level. Appropriate treatment of depression and anxiety may be helpful for the effectiveness of peritoneal dialysis in these patients.%目的 探究持续性不卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者抑郁焦虑的发病状况,了解影响维持性腹膜透析患者焦虑和抑郁产生的相关因素,探讨腹膜透析患者焦虑和抑郁与Engle系数,依从性,合并症,营养状态等的关系,旨在提高PD患者的生存质量. 方法 采用横断面调查,调查75例CAPD治疗患者的一般情况及原发病因;采用Engle系数评估患者的家庭经济状况；应用Hamilton焦虑、抑郁等级量表评估CAPD患者焦虑、抑郁发生状况;采用MDRD方程计算肌酐清除率,以评估患者的残余肾功能;以主观综合性营养评估(subjective global assessment,SGA)同时结合血生化指标评估患者营养状况;用Charlson指数评估患者合并症情况;采用ECOG和Karnofsky活动指数评分评估患者的活动能力. 结果 75例CAPD患者中,抑郁焦虑症状总体发生率为37.33％.抑郁焦虑症状的发生与疾病状况及经济状况有关(P＜0.05).腹膜透析合并焦虑抑郁患者活动能力差、依从性差、合并症多；SGA评估及生化指标显示其营养不良发生率高.精神症状与血红蛋白、白蛋白、血肌酐、尿素氮、Kt/V存在明显负相关(P＜0.01),与营养状态存在明显正相关(P＜0.01);精神症状对营养状态有显著影响(OR=3.610,P=0.025).结论 抑郁焦虑在腹膜透析患者中的发病率较高,合并抑郁焦虑症状的腹膜透析患者治疗依从性差、合并症多、营养不良的发生率高,抑郁焦虑症状的发生与患者家庭经济状况有相关性,重视腹膜透析患者的抑郁焦虑可以提高腹膜透析的质量.
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