Psychological Distress among Haemodialysis Patients and Their Caregivers: Association between Psychological Distress and Caregiver Burden in a Cross-sectional Study

Objectives: End-stage kidney disease (ESKD) poses a significant global health and economic burden. Patients undergoing haemodialysis (HD) and their caregivers are highly susceptible to psychological distress. This study aimed to assess the prevalence of depression and anxiety among ESKD patients on HD and examine the association between patients’ psychiatric morbidities and caregiver burden. Materials and Methods: A cross-sectional study was conducted over 18 months among 100 ESKD patients receiving maintenance HD and their caregivers. Depression and anxiety were evaluated using the Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A), while caregiver burden was measured using the Kingston Caregiver Stress Scale. Data were analysed using the Chi-square test to determine statistical associations. Results: Among patients, 44% had moderate depression, 20% mild, 20% severe and 15% very severe. Anxiety was mild in 76%, mild-to-moderate in 19% and moderate-to-severe in 4%. Among caregivers, 45% had mild depression, 32% moderate and 8% severe; anxiety was mild in 90% and mild-to-moderate in 10%. Patient’s educational status ( p < 0.0001) and socioeconomic status ( p = 0.043) were significantly associated with HAM-A, while haemoglobin ( p = 0.047) and dialysis frequency ( p = 0.046) correlated with HAM-D. Patient depression scores were strongly associated with caregiver burden ( p = 0.0001). Conclusion: Depression and anxiety are highly prevalent among ESKD patients and caregivers. Psychiatric morbidities were associated with key clinical and social variables. Regular mental health screening and psychosocial interventions should be integrated into routine ESKD care to improve overall well-being.