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Background: A significant percentage of patients on hemodialysis (HD) present with affective disorders such as anxiety and/or depression. The purpose of this study was to explore adaptive mixed affective disorders of patients on HD and to analyze the clinical value of a brief health-related quality-of-life (HRQoL) instrument, the COOP-WONCA charts, in our population of HD patient. Methods: Seventy-five patients (mean age 49.2 years; range 20.1-64.9), who had been on HD for a mean 110 months (range 6.1-364.5 months) were studied. The Beck Depression Inventory (BDI), Hamilton Scale of Depression (HDRS) and Hamilton Scale of Anxiety (HARS) were used. To evaluate patient HRQoL, we used the validated Spanish version of the COOPWONCA charts. Results: Of the 75 patients studied, 44.0% (BDI) and 53.4% (HDRS) had some depressive symptoms which were moderatesevere in 14.7% (BDI) and in 22.7% (HDRS). Anxiety symptoms were observed in 46.6% of the patients (13.3% were of moderate- severe degree). There was a high level of association between both depression scales (BDI and HDRS) (r=0.70; p18), with a sensitivity of 96.8% and a specificity of 75% for this cutoff point. Conclusions: A high percentage of patients on HD present with mixed emotional disorders (anxiety and/or depression); a good correlation is observed between HRQoL and the levels of anxiety and depression in these patients; and measuring HRQoL with the COOP-WONCA charts may help diagnose such problems.