Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2025; 15(7): 103850
Published online Jul 19, 2025. doi: 10.5498/wjp.v15.i7.103850
Correlation between anxiety, depression, self-perceived burden, and psychological resilience in patients with chronic renal failure on maintenance hemodialysis
Yin-Yin Ye, Liang-Fei Tao, Yan-Lang Yang, Yu-Wei Wang, Xiao-Ming Yang, Hai-Hong Xu
Yin-Yin Ye, Yan-Lang Yang, Yu-Wei Wang, Xiao-Ming Yang, Hai-Hong Xu, Department of Nephrology, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui Province, China
Liang-Fei Tao, Emergency Center, Shanghai Baoshan District Medical Emergency Center, Shanghai 201900, China
Co-first authors: Yin-Yin Ye and Liang-Fei Tao.
Author contributions: Ye YY, Tao LF, Yang YL, Wang YW, Yang XM and Xu HH designed the study and were involved in the data acquisition and writing of this article; Ye YY and Tao LF contributed to the analysis of the manuscript; and all authors have read and approved the final manuscript.
Supported by Key Research Fund of Wannan Medical College, No. WK2021ZF15; Research Foundation for Advanced Talents of Wannan Medical College, No. YR202213; Foundation of Anhui Educational Committee, No. 2023AH051759; Excellent Youth Research Project of Anhui Universities; No. 2023AH030107; Horizontal Project of Wannan Medical College, No. 622202504003 and No. 662202404013.
Institutional review board statement: This study was approved by the Ethic Committee of Yijishan Hospital of Wannan Medical College.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors who have taken part in this study have nothing to disclose.
Data sharing statement: No additional data are available.
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: Yin-Yin Ye, Department of Nephrology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu 241001, Anhui Province, China. yeyinyin1986@sohu.com
Received: March 12, 2025
Revised: April 18, 2025
Accepted: May 19, 2025
Published online: July 19, 2025
Processing time: 119 Days and 20.1 Hours
Abstract
BACKGROUND

Research examining the relationships among anxiety, depression, self-perceived burden (SPB), and psychological resilience (PR), along with the determinants of PR, in patients with chronic renal failure (CRF) receiving maintenance hemodialysis (MHD) is limited.

AIM

To investigate the correlation between anxiety, depression, SPB, and PR in patients with CRF on MHD.

METHODS

This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024. The anxiety level was evaluated using the Self-Rating Anxiety Scale (SAS); the depression status was assessed using the Self-Rating Depression Scale (SDS); the SPB was measured using the SPB Scale (SPBS); and the PR was determined using the Connor–Davidson Resilience Scale (CD-RISC). The correlations among the SAS, SDS, SPB, and CD-RISC were analyzed using Pearson’s correlation coefficients. Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.

RESULTS

The SAS, SDS, SPB, and CD-RISC scores of the 225 patients were 45.25 ± 15.36, 54.81 ± 14.68, 32.31 ± 11.52, and 66.48 ± 9.18, respectively. Significant negative correlations were observed between SAS, SDS, SPB, and CD-RISC. Furthermore, longer dialysis vintage (P = 0.015), the absence of religious beliefs (P = 0.020), lower monthly income (P = 0.008), higher SAS score (P = 0.013), and higher SDS score (P = 0.006) were all independent factors that adversely affected the PR of patients with CRF on MHD.

CONCLUSION

Patients with CRF on MHD present with varying degrees of anxiety, depression, and SPB, all of which exhibit a significant negative correlation with their PR. Moreover, longer dialysis vintage, the absence of religious beliefs, lower monthly income, higher SAS score, and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.

Keywords: Chronic renal failure; Maintenance hemodialysis; Anxiety; Depression; Self-perceived burden; Psychological resilience

Core Tip: Our investigation demonstrated clinically significant associations between psychological well-being and psychological resilience (PR) in patients with chronic renal failure undergoing maintenance hemodialysis. We observed an inverse relationship between psychological distress severity and PR levels. The multivariate analysis revealed several independent predictors of diminished PR: Extended dialysis duration, absence of religious beliefs, lower monthly income, and elevated anxiety/depression scores. These findings highlight the need for increased clinical vigilance in these vulnerable subgroups. We recommend incorporating routine mental health screening (e.g., using the Self-Rating Anxiety/Depression Scale) into standard management protocols for this patient population. Furthermore, targeted PR-enhancing interventions should be developed, particularly for long-term dialysis patients, those without religious affiliation, and those with lower socioeconomic status.