# Psychological Distress, Stress, and Personality Traits in Patients Undergoing Chronic Hemodialysis: A Comparative Psychometric Study

## TL;DR

This study compares the psychological health of patients on long-term hemodialysis with healthy individuals, finding higher stress, anxiety, and depression in dialysis patients.

## Contribution

The study provides new insights into the psychological burden of chronic hemodialysis and its association with treatment duration.

## Key findings

- Hemodialysis patients showed significantly higher psychological distress compared to healthy controls.
- Large effect sizes were found for depression and perceived stress in dialysis patients.
- Shorter dialysis duration was linked to higher stress levels, but not to anxiety or depression.

## Abstract

Psychological comorbidity is increasingly recognized as a critical factor influencing outcomes in chronic illness management, particularly in patients with end-stage renal disease (ESRD). The present study examines the psychological burden associated with long-term hemodialysis in patients with ESRD, focusing on emotional distress and maladaptive personality traits. Specifically, it explores group differences between hemodialysis patients and matched healthy controls in levels of stress, anxiety, depression, and psychopathological tendencies, including neuroticism, paranoia, and psychopathy-related traits, as well as exploratory associations with treatment duration. A purposive sample of 60 participants (30 patients undergoing chronic hemodialysis and 30 age- and sex-matched healthy controls) was assessed using validated psychometric instruments: The Hospital Anxiety and Depression Scale, the Pichot Neuroticism and Psychopathy Questionnaire, and a 23-item stress measurement questionnaire adapted to the dialysis context. Both descriptive and inferential statistical analyses were conducted, including independent-samples t-tests and effect size calculations (Cohen’s d). Compared to healthy controls, hemodialysis patients exhibited significantly higher levels of psychological distress across multiple domains. Large between-group effect sizes were observed for depression (Cohen’s d = 1.26) and perceived stress (d = 1.51), while moderate effects were identified for anxiety (d = 0.70), neuroticism (d = 0.58), and psychopathy-related traits (d = 0.82). Exploratory analyses indicated that patients with less than 10 years of dialysis experience reported significantly higher stress levels than those with longer treatment duration, whereas differences in anxiety, depression, and personality traits by dialysis duration were not statistically significant. These findings highlight the substantial emotional burden associated with long-term hemodialysis and underscore the importance of routine psychological screening and early psychosocial interventions to support adaptation, treatment adherence, and quality of life in nephrology care.