Psychiatric Morbidities and Associated Factors among Individuals with End Stage Renal Disease in Lagos, Nigeria

Abstract

Background: Co-morbidity of psychiatric disorders in chronic medical conditions impairs treatment compliance, worsens disease progression as well as impairs quality of life; yet little is known about coexisting psychiatric morbidity in End Stage Renal Disease (ESRD) in sub-Saharan Africa.
Objective: This study is to investigate burden of psychiatric morbidity among individuals with ESRD attending outpatient clinics in Lagos, Nigeria.
Methods: A total of hundred consenting individuals with ESRD were administered socio-demographic and clinical profile questionnaire. This was followed by semi-structured clinical interview using Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to make definitive psychiatric diagnosis.
Results: Of the total participants, 28% had psychiatric morbidity. In term of types of psychiatric disorders, 60.7% had depression, 21.4% had anxiety disorders, 14.3% had adjustment disorder and 3.6% met the diagnosis of harmful use of sedatives. Participants with unemployment (÷ 2= 13.935, p<0.001) and those with financial constraint (FET =13.136, p < 0.005) were more likely to experience psychiatric disorders. In addition, unemployment (OR = 7.500, 95% C.I = 2.4-23.8, p<0.002) was predictive of psychiatric disorders among participants, while financial constraint (OR = 0.105, 95% C.I = 0.011-1.036, p>0.05) was not.
Conclusion: A significant proportion of individuals with ESRD had psychiatric disorder, with depression being most prevalent. Social problems such as unemployment and financial constraint constituted identifiable risk factors for psychiatric disorders in ESRD. Proactive integration of mental health services into ESRD health care design is implied. Strengthening of social with financial supports for people with ESRD from the government and other relevant local or international agencies is advocated.

Key Words: Associated factors; ESRD; Prevalence; Psychiatric Morbidity; sub-Saharan Africa