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Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support

Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support
Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support

BACKGROUND: Depression and anxiety are commonly experienced by people with chronic kidney disease (CKD). This study aimed to evaluate person- and service-level factors associated with depression and anxiety symptoms. We sought to also understand utilisation of mental health treatments and preferences for future psychological support.

METHODS: An online survey recruited participants from six UK kidney services with varying levels of psychosocial provision. The survey was also advertised on social media. Participants completed screening questionnaires for depression and anxiety, alongside questions about mental health history, self-efficacy, treatment and support. The study included adults (18 years or older) living with CKD (stages 3b and above) or those receiving any form of Kidney Replacement Therapy (KRT), including individuals with a functioning kidney transplant. Eligible participants had to complete study measures and be proficient in reading and writing in either English or Welsh, as the survey was administered in these languages. This survey was developed with our Patient and Public Involvement group and was administered from January 2023 until 31st January, 2024 using Qualtrics and RedCap.

RESULTS: Four hundred fifty-eight people completed the survey. Moderate-severe symptoms of depression and anxiety were 37.7% and 26.5%, respectively. Over 50% reported a history of diagnosed depression. In addition to depression, sleep problems and fatigue were identified as future support needs, with over a third indicating a preference for in-centre provision. In case-mix adjusted analysis, there was no variability in depression and anxiety symptoms across centres. Centre location and size were unrelated to symptoms. Age, female gender, current mental health treatments, self-efficacy and perceptions regarding opportunity for support, were associated with symptoms of depression and anxiety. In sub-analysis, there was a negative association between psychosocial staffing levels and depression symptoms.

CONCLUSION: Patient-related factors and behavioural characteristics were related to variation of these symptoms. There was little evidence of symptom variability across centres, although in a small sub-analysis, psychosocial provision showed a weak negative correlation with depression symptoms. Our findings highlight preferences of future needs which could be helpful for designing future research and service provision.

Adult, Aged, Anxiety/epidemiology, Depression/epidemiology, Female, Humans, Male, Mental Health, Middle Aged, Patient Preference, Renal Insufficiency, Chronic/psychology, Surveys and Questionnaires, United Kingdom/epidemiology, Mental health, Depression, Chronic kidney disease, Anxiety
1121-8428
675-686
Chilcot, Joseph
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Pearce, Christina J
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Hall, Natalie
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Rehman, Zara
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Norton, Sam
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Griffiths, Sophie
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Hudson, Joanna L
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Mackintosh, Lucy
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Busby, Amanda
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Wellsted, David
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Jones, Julia
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Sharma, Shivani
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Ormandy, Paula
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Palmer, Nick
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Schmill, Pooja
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Da Silva-Gane, Maria
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Morgan, Neal
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Poulikakos, Dimitrios
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Veighey, Kristin
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Robertson, Stuart
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Elias, Rob
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Farrington, Ken
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Chilcot, Joseph
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Pearce, Christina J
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Hall, Natalie
db15d73e-7cbe-4579-a551-b061c003f6d1
Rehman, Zara
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Norton, Sam
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Griffiths, Sophie
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Hudson, Joanna L
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Mackintosh, Lucy
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Busby, Amanda
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Wellsted, David
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Jones, Julia
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Sharma, Shivani
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Ormandy, Paula
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Palmer, Nick
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Schmill, Pooja
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Da Silva-Gane, Maria
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Morgan, Neal
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Poulikakos, Dimitrios
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Veighey, Kristin
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Robertson, Stuart
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Elias, Rob
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Farrington, Ken
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Chilcot, Joseph, Pearce, Christina J, Hall, Natalie, Rehman, Zara, Norton, Sam, Griffiths, Sophie, Hudson, Joanna L, Mackintosh, Lucy, Busby, Amanda, Wellsted, David, Jones, Julia, Sharma, Shivani, Ormandy, Paula, Palmer, Nick, Schmill, Pooja, Da Silva-Gane, Maria, Morgan, Neal, Poulikakos, Dimitrios, Veighey, Kristin, Robertson, Stuart, Elias, Rob and Farrington, Ken (2025) Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support. Journal of Nephrology, 38 (2), 675-686, [e036931]. (doi:10.1007/s40620-024-02194-1).

Record type: Article

Abstract

BACKGROUND: Depression and anxiety are commonly experienced by people with chronic kidney disease (CKD). This study aimed to evaluate person- and service-level factors associated with depression and anxiety symptoms. We sought to also understand utilisation of mental health treatments and preferences for future psychological support.

METHODS: An online survey recruited participants from six UK kidney services with varying levels of psychosocial provision. The survey was also advertised on social media. Participants completed screening questionnaires for depression and anxiety, alongside questions about mental health history, self-efficacy, treatment and support. The study included adults (18 years or older) living with CKD (stages 3b and above) or those receiving any form of Kidney Replacement Therapy (KRT), including individuals with a functioning kidney transplant. Eligible participants had to complete study measures and be proficient in reading and writing in either English or Welsh, as the survey was administered in these languages. This survey was developed with our Patient and Public Involvement group and was administered from January 2023 until 31st January, 2024 using Qualtrics and RedCap.

RESULTS: Four hundred fifty-eight people completed the survey. Moderate-severe symptoms of depression and anxiety were 37.7% and 26.5%, respectively. Over 50% reported a history of diagnosed depression. In addition to depression, sleep problems and fatigue were identified as future support needs, with over a third indicating a preference for in-centre provision. In case-mix adjusted analysis, there was no variability in depression and anxiety symptoms across centres. Centre location and size were unrelated to symptoms. Age, female gender, current mental health treatments, self-efficacy and perceptions regarding opportunity for support, were associated with symptoms of depression and anxiety. In sub-analysis, there was a negative association between psychosocial staffing levels and depression symptoms.

CONCLUSION: Patient-related factors and behavioural characteristics were related to variation of these symptoms. There was little evidence of symptom variability across centres, although in a small sub-analysis, psychosocial provision showed a weak negative correlation with depression symptoms. Our findings highlight preferences of future needs which could be helpful for designing future research and service provision.

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Accepted/In Press date: 8 December 2024
e-pub ahead of print date: 12 January 2025
Published date: 12 January 2025
Additional Information: Publisher Copyright: © The Author(s) 2025.
Keywords: Adult, Aged, Anxiety/epidemiology, Depression/epidemiology, Female, Humans, Male, Mental Health, Middle Aged, Patient Preference, Renal Insufficiency, Chronic/psychology, Surveys and Questionnaires, United Kingdom/epidemiology, Mental health, Depression, Chronic kidney disease, Anxiety

Identifiers

Local EPrints ID: 503135
URI: http://eprints.soton.ac.uk/id/eprint/503135
ISSN: 1121-8428
PURE UUID: 58c51609-2baa-4739-84fb-03abf6f3c72d
ORCID for Kristin Veighey: ORCID iD orcid.org/0000-0003-4903-1847

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Date deposited: 22 Jul 2025 16:44
Last modified: 13 Sep 2025 02:15

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Contributors

Author: Joseph Chilcot
Author: Christina J Pearce
Author: Natalie Hall
Author: Zara Rehman
Author: Sam Norton
Author: Sophie Griffiths
Author: Joanna L Hudson
Author: Lucy Mackintosh
Author: Amanda Busby
Author: David Wellsted
Author: Julia Jones
Author: Shivani Sharma
Author: Paula Ormandy
Author: Nick Palmer
Author: Pooja Schmill
Author: Maria Da Silva-Gane
Author: Neal Morgan
Author: Dimitrios Poulikakos
Author: Kristin Veighey ORCID iD
Author: Stuart Robertson
Author: Rob Elias
Author: Ken Farrington

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