A Comparative Study Concerning the Psychopathologies between the Patients with Chronic Renal Failure and Those with Chronic Hepatitis: Focused on Medically-ill Outpatients Compared with Controlled Subjects who Received Medical Examination

Hong, Young Jae; Ock, Jong Han; Kong, Jin Min; Kim, Yong Gwan; Kim, Jeong Gee

Abstract

OBJECTIVES
Although there were many studies examining anxiety and depression in hospitalized medically-ill patients, there were few studies in examining anxiety and depression of non-psychiatric outpatients or comparative studies among the disease categories. Therefore, we wanted to explore 1) psychopathologies in the patients with chronic renal failure and those with chronic hepatitis, 2) differences of psychopathologies by severity, 3) differences of psychopathologies by the duration of illness, and 4) psychiatric consultation. This was the second series of the whole project.
METHODS
From March to April 1999, 38 patients with chronic renal failure and 26 patients with chronic hepatitis who visited the medical outpatient department are included in the subject group and 116 persons who visited the health examination center in September 1999 are included in the control group. We reviewed the medical records of the patients and inquired what they thought the causes of their illness were. We evaluated the patients with State-trait anxiety inventory, Beck depression inventory, Symptom checklist-90-Revision.
RESULTS
In state anxiety, 62.2% of the patients with chronic renal failure fell into the anxious group, which is somewhat greater than the 52.0% of those with chronic hepatitis. The rates in both subjects are significantly higher than that of the control group. 16.7% of the patients with chronic renal failure were depressed, which is somewhat greater than the 9.1% found in chronic hepatitis. The rates in both subjects showed no significant difference from that of the control group. When the state anxiety scores were compared during the duration of the illness, it was found to be relatively higher during the early phase of disease in both the chronic renal failure patients and the chronic hepatitis patients. In the depression, the scores were found to be relatively higher in the chronic renal failure patients when the duration of illness was between 1 to 5 years compared to other duration groups, while the patients of chronic hepatitis were found to be relatively constant. Most frequently, 36.2% of the patients with chronic renal failure and 24.3% of those with chronic hepatitis thought the cause of their illness to be 'psychological', but the rates of psychiatric consultation in both subjects are 5.7%, 7.7% respectively.
CONCLUSIONS
Our results suggest that proper psychiatric interventions are not being conducted yet and more cooperative and integrative roles are required among psychiatrists and internists.