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      Calidad de vida relacionada con la salud y prevalencia de síntomas depresivos y ansiosos en pacientes en hemodiálisis, en seis unidades renales de Bogotá, Colombia Translated title: Health-Related Quality of Life and Prevalence of Depression and Anxiety Symptoms in Patients in Hemodyalisis from Six Hemodyalisis Units in Bogotá, Colombia.

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          Abstract

          Introducción: La insuficiencia renal crónica (IRC) es un problema de salud pública. La patología psiquiátrica en esta población puede repercutir en la calidad de vida relacionada con la salud (CVRS). La mayoría de estudios sobre CVRS y los síntomas depresivos y/o ansiosos no son latinoamericanos. Objetivo: determinar la CVRS y la prevalencia de depresión y ansiedad en pacientes de seis unidades renales de Bogotá, Colombia. Método: Estudio multicéntrico, descriptivo, de corte trasversal, en adultos de ambos sexos con IRC y que reciben tres sesiones semanales de hemodiálisis. Se les administraron las fichas de datos sociodemográficos SF-36 y HADS. Resultados: 174 sujetos participaron en el estudio, de los cuales 163 fueron considerados para el análisis final (entre 19 y 86 años de edad; 57,06% hombres). La CVRS física general fue de 38,70 (DE 8,62) y la CVRS mental general, de 44,73 (DE 10,39). Se sospecha de depresión en 15,95%, de problema clínico en 5,52%, de ansiedad en 16,46%. Se presenta un problema clínico en 13,29%. Conclusiones: Este estudio usa la muestra latinoamericana más grande de la que se tenga conocimiento. La CVRS es comparable con la hallada en otras poblaciones, excepto por el rango anormalmente bajo de desempeño físico. Al situar el punto de corte de la HADS para depresión en 9, se podría aumentar su sensibilidad aumentando la prevalencia de depresión. Conforme desciende la CVRS mental general, es mayor la presencia de depresión; a medida que desciende la CVRS total, es más probable la existencia de un cuadro ansioso.

          Translated abstract

          Introduction: End-Stage Renal Disease (ESRD) is a major health problem. Psychiatric comorbidity could affect Health-Related Quality of Life (HRQL). Most studies analyzing HRQL as well as depressive and/or anxiety symptoms have been undertaken in non-Latin-American populations. Objective: To determine HRQL and the prevalence of depression and anxiety in patients assisting to six hemodialysis (HD) units in Bogotá, Colombia. Method: Multicentric, descriptive, transversal study in patients over 18 of both genders with ESRD, who were receiving HD three times per week. A sociodemographic questionnaire, the SF-36, and the HADS were administered. Results: 174 subjects participated in the study, but only 163 were considered for the final analysis (ages ranged from 19 to 86 years old; 57.06 were males). The physical HRQL was 38.70 (SD 8.62) and the mental HRQL was 44.73 (SD 10.39). Depression was suspected in 15.95% and a clinical problem was present in 5.52% of the cases. Anxiety was suspected in 16.46% of the subjects and a clinical problem existed in 13.29% of them. Conclusions: This is the largest Latin-American sample known of to date. HRQL was comparable to other populations except for the Role-Physical, which is the lowest described in the literature. With the intention of increasing sensibility, the cut point of 9 might be the more appropriate when screening for depression with the HADS. As mental HRQL decreases, the presence of depression increases; as total HRQL decreases, the possibility of finding anxiety increases.

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          Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.

          Anxiety, although as common as depression, has received less attention and is often undetected and undertreated. To determine the current prevalence, impairment, and comorbidity of anxiety disorders in primary care and to evaluate a brief measure for detecting these disorders. Criterion-standard study performed between November 2004 and June 2005. 15 U.S. primary care clinics. 965 randomly sampled patients from consecutive clinic patients who completed a self-report questionnaire and agreed to a follow-up telephone interview. 7-item anxiety measure (Generalized Anxiety Disorder [GAD]-7 scale) in the clinic, followed by a telephone-administered, structured psychiatric interview by a mental health professional who was blinded to the GAD-7 results. Functional status (Medical Outcomes Study Short Form-20), depressive and somatic symptoms, and self-reported disability days and physician visits were also assessed. Of the 965 patients, 19.5% (95% CI, 17.0% to 22.1%) had at least 1 anxiety disorder, 8.6% (CI, 6.9% to 10.6%) had posttraumatic stress disorder, 7.6% (CI, 5.9% to 9.4%) had a generalized anxiety disorder, 6.8% (CI, 5.3% to 8.6%) had a panic disorder, and 6.2% (CI, 4.7% to 7.9%) had a social anxiety disorder. Each disorder was associated with substantial impairment that increased significantly (P < 0.001) as the number of anxiety disorders increased. Many patients (41%) with an anxiety disorder reported no current treatment. Receiver-operating characteristic curve analysis showed that both the GAD-7 scale and its 2 core items (GAD-2) performed well (area under the curve, 0.80 to 0.91) as screening tools for all 4 anxiety disorders. The study included a nonrandom sample of selected primary care practices. Anxiety disorders are prevalent, disabling, and often untreated in primary care. A 2-item screening test may enhance detection.
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            Guidelines for the management of chronic kidney disease.

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              Chronic kidney disease and its complications.

              Chronic kidney disease (CKD) is a complex disease affecting more than 20 million individuals in the United States. Progression of CKD is associated with a number of serious complications, including increased incidence of cardiovascular disease, hyperlipidemia, anemia, and metabolic bone disease. CKD patients should be assessed for the presence of these complications and receive optimal treatment to reduce their morbidity and mortality. A multidisciplinary approach is required to accomplish this goal.
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                Author and article information

                Journal
                rcp
                Revista Colombiana de Psiquiatría
                rev.colomb.psiquiatr.
                Asociacion Colombiana de Psiquiatria. (Bogotá, Distrito Capital, Colombia )
                0034-7450
                December 2009
                : 38
                : 4
                : 622-636
                Affiliations
                [03] Bogotá orgnamePontificia Universidad Javeriana Colombia
                [05] Bogotá orgnamePontificia Universidad Javeriana Colombia
                [02] Bogotá orgnamePontificia Universidad Javeriana Colombia
                [01] San Pedro Montes De Oca orgnameUniversidad de Costa Rica Costa Rica
                [04] Bogotá orgnamePontificia Universidad Javeriana Colombia
                Article
                S0034-74502009000400004 S0034-7450(09)03800404
                01187bdb-0576-45a3-80aa-5e25717ad35e

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 05 November 2009
                : 02 September 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 15
                Product

                SciELO Colombia

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Articulo Original

                hemodiálisis,depresión,ansiedad,calidad de vida relacionada con la salud,Hemodialysis,depression,anxiety,health related quality of life

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