Li JB, Ye XB, Tu XJ. Interaction between anxiety, depression, and low resilience predicts poor prognosis in patients with chronic kidney disease. World J Psychiatry 2025; 15(11): 110699 [DOI: 10.5498/wjp.v15.i11.110699]
Corresponding Author of This Article
Jiang-Bo Li, Department of Psychosomatic, Jianyang People’s Hospital, No. 180 Hospital Road, Jianyang 641400, Sichuan Province, China. 1015950973@qq.com
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Psychiatry
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 19, 2025 (publication date) through Nov 4, 2025
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World Journal of Psychiatry
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2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Li JB, Ye XB, Tu XJ. Interaction between anxiety, depression, and low resilience predicts poor prognosis in patients with chronic kidney disease. World J Psychiatry 2025; 15(11): 110699 [DOI: 10.5498/wjp.v15.i11.110699]
World J Psychiatry. Nov 19, 2025; 15(11): 110699 Published online Nov 19, 2025. doi: 10.5498/wjp.v15.i11.110699
Interaction between anxiety, depression, and low resilience predicts poor prognosis in patients with chronic kidney disease
Jiang-Bo Li, Xiao-Bin Ye, Xi-Jin Tu
Jiang-Bo Li, Department of Psychosomatic, Jianyang People’s Hospital, Jianyang 641400, Sichuan Province, China
Xiao-Bin Ye, Xi-Jin Tu, Department of Psychiatry, Zhangzhou Fourth People’s Hospital, Zhangzhou 363000, Fujian Province, China
Co-first authors: Jiang-Bo Li and Xiao-Bin Ye.
Author contributions: Li JB and Ye XB contributed to the research and design and they contributed equally to this manuscript as co-first authors. Li JB, Ye XB, and Tu XJ wrote the manuscript. All authors contributed to this work and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Bo Li, Department of Psychosomatic, Jianyang People’s Hospital, No. 180 Hospital Road, Jianyang 641400, Sichuan Province, China. 1015950973@qq.com
Received: June 13, 2025 Revised: July 9, 2025 Accepted: September 18, 2025 Published online: November 19, 2025 Processing time: 144 Days and 20 Hours
Abstract
Patients with chronic kidney disease (CKD), particularly those undergoing maintenance hemodialysis (MHD), often experience mental health issues. Recent studies have indicated a significantly elevated prevalence of anxiety and depression coupled with reduced resilience in this population. The complex interaction between these three factors is exacerbated by multiple negative influences. This study reviews recent advances in research on the relationship between mental health impairment, quality of life (QoL), and prognosis in patients with CKD. The findings revealed that prolonged MHD dependence, economic burden of healthcare, and other psychological factors diminish patients’ resilience and intensify negative emotions (e.g., anxiety and depression). The interactions between negative emotions and physiology create a vicious cycle, deteriorating QoL and clinical outcomes. We propose that patients with long-term MHD-dependent CKD should be classified as a high-risk group for mental health impairments that need regular psychological screening and personalized psycho-medical interventions. This integrated management model may help improve negative emotions and disrupt the bidirectional psychophysiological interplay, offering a novel clinical pathway for improving the QoL and prognosis.
Core Tip: Studies have revealed that patients with chronic kidney disease (CKD) on long-term hemodialysis may experience mental health impairment. Multiple factors can exacerbate anxiety and depression; it interacts with the physiological processes of CKD, forming a pathological psychophysiological interaction mechanism that affects their quality of life and prognosis. A comprehensive management approach for patients with CKD should include a multidisciplinary medical team, personalized non-pharmacological intervention, and integrated pharmacological therapy. Assessing the risk-benefit ratio of antidepressants and hypnotics and drug intervention combined with non-drug intervention may help alleviate anxiety and depression, improve quality of life, break the psychophysiological vicious cycle, and optimize long-term outcomes.
