Robbert W Schouten1, Els Nadort2, Victor Harmse2, Adriaan Honig3, Wouter van Ballegooijen4, Birit F P Broekman3, Carl E H Siegert5. 1. Department of Nephrology, OLVG hospital, Amsterdam, the Netherlands. Electronic address: r.schouten@olvg.nl. 2. Department of Psychiatry, OLVG hospital, Amsterdam, the Netherlands. 3. Department of Psychiatry, OLVG hospital, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, Amsterdam, the Netherlands. 4. Department of Clinical Psychology, Amsterdam UMC, VUmc, Amsterdam, the Netherlands; Department of Specialized Mental Health Care, GGZ Ingeest, Amsterdam, the Netherlands. 5. Department of Nephrology, OLVG hospital, Amsterdam, the Netherlands.
Abstract
OBJECTIVE: Symptoms of anxiety are highly prevalent in dialysis patients and are associated with adverse clinical outcomes. Identifying symptom dimensions may help to understand the pathophysiology, improve screening and guide treatment. Currently, there are no data on symptom dimensions of anxiety in dialysis patients. This study aimed to identify the best fitting dimensional model for anxiety in dialysis patients and assess the association between symptom dimensions of anxiety and adverse clinical outcomes. METHODS: This study is a prospective observational cohort study including patients from 10 urban dialysis centers between 2012 and 2017. Anxiety symptoms were measured using the self-reported questionnaire Beck Anxiety Inventory. Confirmatory factor analysis was used to identify symptom dimensions. The association between dimensions and mortality, hospitalization and quality of life was investigated using stepwise cox, poisson and lineair regression models. Multivariable models included demographic, social, laboratory and clinical variables to adjust for possible confounding. RESULTS: In total 687 chronic dialysis patients were included. A Somatic and Subjective anxiety dimension were identified. Only Somatic anxiety symptoms showed an association with increased risk of hospitalization and mortality (Rate Ratio 1.73 (1.45-2.06) p = .007 and Hazard Ratio 1.65 (1.15-2.37) p = .007 respectively). These associations were independent from somatic comorbidity. All symptom dimensions of anxiety showed an association with Quality of Life. CONCLUSION: This study shows that anxiety is common in chronic dialysis patients and comprises of a somatic, subjective, and a total score. The discrimination between anxiety dimensions can be useful for clinical practice, as they are related to different clinical outcomes.
OBJECTIVE: Symptoms of anxiety are highly prevalent in dialysis patients and are associated with adverse clinical outcomes. Identifying symptom dimensions may help to understand the pathophysiology, improve screening and guide treatment. Currently, there are no data on symptom dimensions of anxiety in dialysis patients. This study aimed to identify the best fitting dimensional model for anxiety in dialysis patients and assess the association between symptom dimensions of anxiety and adverse clinical outcomes. METHODS: This study is a prospective observational cohort study including patients from 10 urban dialysis centers between 2012 and 2017. Anxiety symptoms were measured using the self-reported questionnaire Beck Anxiety Inventory. Confirmatory factor analysis was used to identify symptom dimensions. The association between dimensions and mortality, hospitalization and quality of life was investigated using stepwise cox, poisson and lineair regression models. Multivariable models included demographic, social, laboratory and clinical variables to adjust for possible confounding. RESULTS: In total 687 chronic dialysis patients were included. A Somatic and Subjective anxiety dimension were identified. Only Somatic anxiety symptoms showed an association with increased risk of hospitalization and mortality (Rate Ratio 1.73 (1.45-2.06) p = .007 and Hazard Ratio 1.65 (1.15-2.37) p = .007 respectively). These associations were independent from somatic comorbidity. All symptom dimensions of anxiety showed an association with Quality of Life. CONCLUSION: This study shows that anxiety is common in chronic dialysis patients and comprises of a somatic, subjective, and a total score. The discrimination between anxiety dimensions can be useful for clinical practice, as they are related to different clinical outcomes.
Authors: Els Nadort; Nadine Rijkers; Robbert W Schouten; Ellen K Hoogeveen; Willem J W Bos; Louis Jean Vleming; Michiel Westerman; Marcel Schouten; Marijke J E Dekker; Yves F C Smets; Prataap Chandie Shaw; Karima Farhat; Friedo W Dekker; Patricia van Oppen; Carl E H Siegert; Birit F P Broekman Journal: J Psychosom Res Date: 2022-04-14 Impact factor: 4.620
Authors: Els Nadort; Noëlle J K van Geenen; Robbert W Schouten; Rosa E Boeschoten; Prataap Chandie Shaw; Louis Jean Vleming; Marcel Schouten; Karima Farhat; Friedo W Dekker; Patricia van Oppen; Carl E H Siegert; Birit F P Broekman Journal: J Pers Med Date: 2022-06-30