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May 10, 2022
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Mental illness is commonly reported among adults with CKD

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Mental illness is common among adults with chronic kidney disease in the United States, according to data published in Kidney International Reports.

Further, investigators wrote that treating mental health needs could improve treatment outcomes and quality of life.

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“Among adults with CKD or kidney failure, comorbid mental illness is associated with reduced treatment adherence and increased risk of hospitalization, readmission and death. Moreover, severe mental illness that impairs functioning is often seen as a contraindication to transplantation and home dialysis, which the Centers for Medicare and Medicaid Services (U.S. Department of Health and Human Services) aims to help adults with CKD use more often under ongoing payment and delivery reforms,” Adam S. Wilk, PhD, from the department of health policy and management of Rollins School of Public Health at Emory University, and colleagues wrote.

In an observational study, researchers evaluated mental illness among 152,069 adults aged 22 years and older. Participants were categorized as adults with no reported chronic conditions (n=117,235), adults reporting hypertension and/or diabetes but not CKD (n=32,290) and adults reporting CKD (n=2,544). Researchers used data from the 2015 to 2019 National Survey on Drug Use and Health.

Using logistic regression models, researchers compared prevalence of any mental illness, serious mental illness, mental health treatment and unmet mental health care needs across the groups. Researchers used dichotomous indicators to measure the prevalence of mental health conditions, as well as mental health treatment and perceived unmet treatment need.

Analyses revealed about 26.6% of participants reporting CKD also had mental illness, 7.1% of which had a serious mental illness. Researchers found adults reporting CKD were more likely to have mental illness than those without chronic conditions or with hypertension or diabetes but not CKD. Similarly, those reporting CKD were more likely to have any mental health treatment and to have unmet mental health care needs.

“This study presents the first U.S.-national, population-level estimates of mental health care needs and treatment among adults with self-reported CKD. High levels of mental illness and unmet needs for mental health care among U.S. adults with self-reported CKD point to important opportunities for more effectively integrating [mental health] MH and CKD care and managing this population’s mental health needs,” Wilk and colleagues wrote. “Comprehensive and integrated care delivery models should be evaluated as tools for managing the heightened medical and mental health needs of adults with CKD.”