BACKGROUND Chronic kidney disease (CKD) is a major health issue to be discussed in this current era due to its increasing prevalence. The burden due to chronic kidney disease is very high especially in low and middle income countries. The prevalence of psychiatric morbidity is high in patients undergoing haemodialysis. The presence of psychiatric illness increases the risk of hospitalisation and mortality in patients with end stage renal disease. This study was conducted to assess the psychiatric morbidity of patients with chronic kidney disease on maintenance haemodialysis. METHODS Descriptive research design was used for the study. The sample of the study consisted of 180 patients above the age of 18 years with chronic kidney disease undergoing maintenance haemodialysis. A specially designed pro-forma, ICD 10 symptoms check list, and ICD 10 diagnostic criteria for research are the tools used for the study. RESULTS Most of the patients were from 41 - 50 years age group (27.8 %) with a mean age of 47.43 and majority were males (74.4 %). 45.6 % patients had plan for renal transplant and 62.2 % patients were on twice weekly haemodialysis. The primary diagnosis was chronic glomerulonephritis in 33.9 % and diabetic nephropathy in 32.8 % of study participants. 11.7 % of study participants had IgA nephropathy and 9.4 % of study participants had ischemic renal failure. 23.9% of participants were found to have psychiatric morbidity. The most common psychiatric illness was depression which was reported in 15.0 % of study population. 6.1 % of participants had adjustment disorder, 2.2 % had anxiety disorder and 0.6 % had psychosis. The mean duration of dialysis was 2 years in patients with psychiatric illness. CONCLUSIONS A male preponderance was found in the study population. High psychiatric morbidity is found among patients undergoing haemodialysis and depression is the most common psychiatric disorder identified. KEYWORDS Psychiatric Morbidity, Haemodialysis

BACKGROUND Bipolar disorder is a chronic psychiatric illness of an episodic and recurrent nature with marked mood and behavioural dysfunction and causes substantial psychosocial morbidity, as it frequently affects independent living, vocational, and social activities. But there is a relative dearth of Indian research about the factors associated with risk of recurrence in patients with BPAD receiving treatment according to contemporary practice guidelines The aim of this study was to assess the association of psychosocial and treatment factors with frequency of episodes in Bipolar Affective Disorder (BPAD). MATERIALS AND METHODS A cross-sectional study consisted of first 120 subjects with bipolar disorder who availed psychiatry services in a general hospital setting in central Kerala from January 2014 to July 2014. Diagnosis was made by DCR-10 criteria. Data for 114 subjects with BPAD were analysed. Episode frequency was estimated as the number of episodes of depression, mania, hypomania and mixed per year of illness. Stressful life events were assessed by Presumptive Stressful Life Event scale and treatment adherence by Drug Attitude Inventory. Modified Camberwell Family Interview was used for assessing expressed emotions. Kuppuswamy's Socio Economic Scale was used for assessing socioeconomic status (SES). RESULTS Episode frequency was significantly associated with young age group, female sex, low educational status (Primary), unemployment, lower socioeconomic class, marital status (Single), number of children (Zero), earlier age at onset, family history of BPAD, high stressful life events, high expressed emotions, and poor treatment adherence. The association of comorbid general medical condition and psychiatric condition with episode frequency were not significant. The influence of religion, family type and comorbid substance use on episode frequency could not be commented upon. CONCLUSION Episode frequency was significantly associated psychosocial and treatment factors. Hence, to reduce the recurrence in BPAD, specific interventions are required to change the modifiable risk factors.

BACKGROUND Chronic kidney disease (CKD) is a major health issue around the globe. The illness and its treatment affect both the patients and care givers life. Care giving can have varying effects on the caregiver’s life. It can disrupt the family routines, can contribute to occupational and financial problems and can affect the physical and psychological health of the carer. The purpose of this study was to assess the caregiver burden and resilience of the caregivers of patients undergoing maintenance haemodialysis. METHODS This is a cross-sectional study. The sample of the study consisted of caregivers of 180 patients with chronic kidney disease undergoing maintenance haemodialysis. Specially designed pro-forma, Burden Scale for Family Caregivers (BSFC), Brief Resilience Scale (BRS) are the tools used for the study. RESULTS The mean age of patients in bystanders with significant caregiver burden was 47.36 years and those with low burden was 48.12 years respectively. Among the 180 care givers, 8.9 % had low burden and 91.1 % had significant burden. Resilience was low in 27.2 % of caregivers, medium in 72.2 % and high in 0.6 % of caregivers. The mean BRS score was 3.81 + 0.473 in low burden group against a BRS score of 3.15 + 0.543 in significant burden group. There was a significant association between caregiver resilience and caregiver burden. CONCLUSIONS Chronic kidney disease, due to its long course and prolonged treatment, affects the physical, psychological and social spheres of patient and family. This may result in the feeling of burden among caregivers and affects the various aspects of carer’s life. Burden was high and resilience was low among the caregivers of patients with CKD. Attention should be given to the strategies to support the caregivers. KEYWORDS Care Giver Burden, Resilience, Chronic Kidney Disease