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Major depressive disorder in hemodialysis patients in China
Aimin Hu1, Zhimin Xue, Tumbwene E Mwansisya
1Institute of Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China; Department of Medicine, Jishou University, Jishou, China.
Insights
Major depressive disorder (MDD) is common in hemodialysis (HD) patients in China, with 10% diagnosed. Most cases show severe symptoms, and none were previously diagnosed or treated, highlighting a need for screening.
Area of Science:
- Nephrology
- Psychiatry
- Public Health
Background:
- Major depressive disorder (MDD) is a prevalent psychiatric condition in hemodialysis (HD) patients.
- Limited research exists on MDD prevalence and characteristics within HD populations in Mainland China.
Purpose of the Study:
- To determine the prevalence of MDD in HD patients in Mainland China.
- To investigate sociodemographic and clinical factors associated with MDD in this population.
- To assess the current diagnosis and treatment status of MDD among HD patients.
Main Methods:
- Screening of 260 HD patients using the nine-item Patient Health Questionnaire.
- Formal MDD diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria.
- Assessment of depressive symptom severity using the Hamilton Rating Scale for Depression.
- Comparison of demographic and clinical characteristics between patients with and without MDD.
Main Results:
- A 10% prevalence of confirmed MDD was found among the 260 HD patients.
- 69.2% of HD patients with MDD experienced severe or very severe depressive symptoms.
- No prior clinical diagnosis or treatment for MDD was recorded in any patient's medical history.
- Shorter HD duration, lower monthly income, and lower blood urea nitrogen levels were associated with a higher likelihood of MDD.
Conclusions:
- MDD is a frequent and underdiagnosed condition in hemodialysis patients.
- Regular screening and professional diagnosis are crucial for improving MDD detection and treatment rates.
- Further research is needed to evaluate the effectiveness of interventions for MDD in HD patients.
Introduction:
Major depressive disorder (MDD) has been regarded as the most common psychiatric disorder among hemodialysis (HD) patients. However, few studies have investigated MDD in HD patients in Mainland China. This study sought to investigate the prevalence and treatment of MDD, as well as the sociodemographic and clinical characteristics in this population.
Methods:
Two hundred sixty HD patients were screened with the nine-item Patient Health Questionnaire, and the formal diagnosis of MDD was further assessed using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Severity of depressive symptoms was assessed with Hamilton Rating Scale for Depression. Finally, patients meeting diagnostic criteria were compared with those who did not on demographic and clinical characteristics.
Results:
Among the 260 subjects, 26.2% screened positively and 10% were confirmed to have a diagnosis of MDD. Among HD patients with MDD, 69.2% had severe or very severe depressive symptoms. There was no evidence of a clinical diagnosis or of treatment for MDD in any of the patients' medical records. Those with shorter duration of HD, lower monthly income, and lower levels of blood urea nitrogen were significantly more likely to have a diagnosis of MDD.
Discussion:
MDD is frequent in HD patients. Regular screening and professional diagnosis should be undertaken to increase the detection and treatment of MDD in HD patients. The effectiveness of interventions for MDD in HD patients deserves further research.
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