• Felt stigma is significantly associated with suicidal ideation in epilepsy. • Depression mediates the effect of stigma on suicide risk among people with epilepsy. • Perceived overprotection correlate with stigma but not directly with suicidality. • This is the first study linking stigma, overprotection, and suicidality in epilepsy. • Addressing psychosocial factors may help reduce suicide risk in epilepsy care.

Objective: To compare sleep quality, daytime sleepiness, and circadian rhythm characteristics across clinically defined chronic kidney disease (CKD) groups and to examine their relative contribution to global subjective sleep quality. Method: This two-center, cross-sectional study enrolled 344 adults with CKD (response rate: 96.6%) from nephrology settings in Turkey. Participants were classified into three groups: mild-to-moderate CKD (KDIGO stages 2-3; n = 133), advanced CKD without dialysis (stages 4-5; n = 37), and dialysis-dependent CKD (stage 5D; n = 174). Sleep quality, daytime sleepiness, and circadian rhythm parameters were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Munich Chronotype Questionnaire (MCTQ). Hierarchical regression identified predictors of PSQI global scores. Results: ESS total scores were significantly higher in the dialysis-dependent group compared with both other groups (ε ² = 0.182, the only large effect size), whereas PSQI global scores were paradoxically lower in this group (adjusted P = 0.021). Biological chronotype (MSFsc) did not differ across groups. In hierarchical regression, ESS (β = 0.525) and dialysis-dependent status (β = −0.318) were the only significant predictors of PSQI global scores, with sleep–wake variables adding 24.3% explained variance beyond demographic and clinical factors. Conclusions: CKD-related sleep–wake burden is more prominently reflected in daytime sleepiness and social–circadian disorganization than in global subjective sleep quality. Assessment of daytime sleepiness may improve recognition of sleep–wake dysregulation in nephrology settings.

Background and Objectives: Adult separation anxiety (ASA) has received limited attention in nephrology despite the substantial psychological burden associated with chronic kidney disease (CKD). We examined ASA in CKD in relation to depressive symptoms, parental bonding, perceived expressed emotion, CKD stage, and dialysis status. Materials and Methods: In this multicentre cross-sectional study, 340 adults with CKD (169 dialysis, 171 non-dialysis) were recruited from two tertiary care centres. ASA was assessed with the Adult Separation Anxiety Questionnaire (ASA-27), alongside the Parental Bonding Instrument, Level of Expressed Emotion Scale–Short Form, Beck Depression Inventory (BDI), and Short Form-36 Health Survey. Group comparisons, correlations, multivariate analysis of covariance, and hierarchical linear regression were performed. Results: ASA correlated positively with depressive symptoms (rho = 0.450), maternal overprotection (rho = 0.412), expressed emotion (rho = 0.336), paternal overprotection (rho = 0.326), and CKD stage (rho = 0.166) and negatively with paternal care (rho = −0.212). Dialysis patients had higher ASA and depressive symptom scores, but these differences did not persist once CKD stage was entered as a covariate (p = 0.169 and p = 0.053), reflecting the near-complete overlap between dialysis status and stage 5 disease. Younger age, female sex, higher maternal overprotection, and greater depressive symptom severity were independently associated with higher ASA scores (adjusted R² = 0.285). Conclusions: ASA appears clinically relevant in CKD and is associated with depressive symptoms and relational factors. Psychosocial assessment in CKD should extend beyond depression. The higher ASA levels observed in dialysis patients cannot be attributed to dialysis treatment itself.