Mental Health of the Refugee and Native Patients with End-Stage Renal Diseases Receiving Hemodialysis During COVID-19 in Istanbul: A Cross-Sectional Study from a Tertiary Center

Abstract
Aim: Patients receiving hemodialysis (HD) are at high risk for developing psychiatric symptoms. The aim of this study is to investigate the levels and correlates of depression, anxiety, somatization and post-traumatic stress disorder (PTSD) symptoms of refugee HD patients and compare to native HD patients. Methods: This is a descriptive study with a cross-sectional design. A total of 58 refugee (n=27) and native (n=31) end-stage renal disease patients receiving HD were included. The data were collected between 14th and 16th of July 2021. Patient health questionnairesomatic, anxiety, and depressive symptoms (PHQ-SADS) scales and posttraumatic-stress disorder checklist for DSM-5 (PCL-5) were used for the clinical assessment. Results: Refugee patients had similar sociodemographic, clinical and HD characteristics with native patients. Anxiety subscale and PCL5 scores were significantly higher in refugee patients (p=0.04 and p=0.03, respectively), while depression and somatization subscales levels did not differ among groups. The age was negatively correlated with depressive symptom levels in refugee patients while somatic symptom levels were positively correlated with depression, anxiety and PTSD symptom levels in both groups. Conclusion: The staff of HD centers should be trained in order to recognize psychiatric disorders and symptoms, and routine psychiatric assessment may contribute to improving the mental health and preventing adverse health outcomes in refugee HD patients.

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