BURDEN OF PSYCHIATRIC COMORBIDITIES AND COGNITIVE DYSFUNCTION IN CHRONIC KIDNEY DISEASE PATIENTS ATTENDING A TERTIARY CARE HOSPITAL

Bhaskar Mara; Vishwanatha Sham Alamela; Shekavva Halli; P. Sandhya; Sushanth R. Jagannavar; Veena S. Pattar

Authors

Bhaskar Mara MD, Associate Professor, Department of Psychiatry, S.N. Medical College, Bagalkot 587103 Author
Vishwanatha Sham Alamela MD, Associate Professor, Department of Psychiatry, S.N. Medical College, Bagalkot 587103 Author
Shekavva Halli MD, Assistant Professor, Department of Radiology, S.N. Medical College, Bagalkot 587103 Author
P. Sandhya MBBS, Junior Resident, Department of Psychiatry, SNMC, Bagalkot - 587103 Author
Sushanth R. Jagannavar MBBS, Junior Resident, Department of Psychiatry, SNMC, Bagalkot - 587103 Author
Veena S. Pattar MD (Ayu), Professor, Dept of Swasthavritta and Yoga, BVVS Ayurvedic Medical College and Hospital, Bagalkot 587101 Author

Keywords:

CKD, Psychiatric Disorder, Dialysis, Depression, GHQ-12, AUDIT, ACE-III.

Abstract

Background: chronic kidney disease (CKD) is a major public health problem associated with substantial physical, psychological, and cognitive morbidity. Psychiatric disorders and cognitive dysfunction are common but often underrecognized among patients with CKD, adversely affecting treatment adherence, quality of life, and clinical outcomes. Aim: To determine the prevalence of psychiatric comorbidities and cognitive dysfunction among patients with chronic kidney disease attending a tertiary care hospital. Materials and Methods: A hospital-based cross-sectional study was conducted among 126 patients with CKD who fulfilled the predefined inclusion and exclusion criteria. Data on sociodemographic characteristics, clinical profile and psychiatric history were collected using a structured proforma. Psychological distress, anxiety, depression and cognitive function were assessed using the General Health Questionnaire-12 (GHQ-12), Hospital Anxiety and Depression Scale (HADS) and Addenbrooke's Cognitive Examination-III (ACE-III), respectively. Results: Of the 126 participants, 69.5% screened positive for psychological distress, indicating a high burden of psychiatric morbidity. Anxiety symptoms were observed in 68.5% of participants, while depressive symptoms were present in 28.3%. Cognitive performance declined with increasing severity of CKD, with patients in Stage 3 demonstrating significantly better cognitive scores than those in Stage 4, whereas individuals receiving haemodialysis exhibited the greatest degree of cognitive impairment. Conclusion: Psychiatric morbidity and cognitive dysfunction are highly prevalent among patients with CKD and become more pronounced with advancing disease severity. Routine screening for psychological disorders and cognitive impairment, along with integrated mental health care within nephrology services, may facilitate early intervention, improve treatment adherence, and enhance overall patient outcomes.