Nearly half of young adults with kidney failure self-reported issues with mental health
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Key takeaways:
- 35% of respondents self-reported at least moderate generalized anxiety disorder.
- Patients receiving dialysis experienced worse mental health.
Young adults with kidney failure are likely to experience an increased risk for depression, anxiety and other mental health issues as they age, according to a letter to the editor published in Kidney Medicine.
“The original SPEAK study gave a snapshot of the psychosocial health of young adults with kidney failure in the U.K. and highlighted poorer life course and psychological outcomes compared to the general population and negative associations between well-being, psychological morbidity and receiving dialysis. This project was a follow-up to try and understand how the psychosocial health of this group evolves as they age,” Mohammed Al-Talib, MBBS, from population health sciences at the University of Bristol in the United Kingdom, told Healio.
Study
After revising the survey used in the original study, researched had 158 participants complete the SPEAK-2 survey between June 2020 and January 2021. Overall, 89% of respondents were transplant recipients. The modified SPEAK-2 survey included the general health questionnaire, the patient health questionnaire (PHQ-9) and the generalized anxiety disorder (GAD-7) scales.
“As well as finding out whether they are able to catch up to their healthy peers in terms of life course outcomes, like employment, relationships and home ownership (the results of which we plan to publish in future), we also wanted to see how their psychological health developed over time,” Al-Talib said. “In this research, we used more specific measures to understand how much of the burden of psychological morbidity could be characterized as depression and/or anxiety, which we had not done in the original SPEAK study.”
Analyses revealed 40% of respondents had PHQ-9 scores of at least moderate depression and 35% had GAD-7 scores of at least moderate generalized anxiety disorder. According to the letter, patients on dialysis scored worse. Further, the mental health of patients declined as they aged.
Moving forward
When asked if future research will be conducted to determine the currently unknown causes of this decline, Al-Talib said, “It is hard to say. Without doubt, the COVID-19 pandemic will have had an impact.”
“There needs to be [a] dedicated long-term follow-up of larger cohorts of patients who develop kidney failure in childhood/young adulthood to truly better understand kidney failure in young adulthood impacts psychosocial health in the long term,” he continued. “Dr. Alexander Hamilton has been undertaking a pilot feasibility study (Kidney PASSPORT) to inform the development of an assistant psychological practitioner role where a trained health care worker can assess and provide support to patients with kidney failure who have mental health difficulties, with the hope of expanding this into a national trial.”
Resources for young adults with kidney failure in the U.K. can be limited, he said. However, Al-Talib suggests the Kidney Care U.K. Young Adult Kidney Group that provides online support to patients aged between 18 and 30 years.
“Some hospitals, including North Bristol NHS Trust where I am based, have specific young adult clinics, which involve a renal psychologist and specialist nurses who can also provide social support advice,” Al-Talib said. “However, our findings make the case for expanded support for this cohort that perhaps should extend beyond the age of 30 [years].”
He concluded, “We should be asking our young adult patients if they are having any difficulties with their mental health and signposting them to available services.”
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