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Depression in hemodialysis patients.
Psychosomatics
|January 1, 1989
Summary
Diagnosing depression in medically ill patients, especially those with end-stage renal disease (ESRD), is challenging. Psychological symptoms like suicidal ideation are more indicative of depression than vegetative symptoms in ESRD patients.
Area of Science:
- Psychiatry
- Nephrology
- Clinical Psychology
Background:
- Diagnostic systems for depression, such as DSM-III-R and Research Diagnostic Criteria (RDC), lack validation in medically ill populations.
- Diagnosing depression in patients with end-stage renal disease (ESRD) presents unique challenges.
- Previous research has not sufficiently addressed depression prevalence and diagnostic symptom utility in ESRD patients undergoing hemodialysis.
Purpose of the Study:
- To determine the prevalence of minor and major depression in patients with ESRD undergoing hemodialysis.
- To evaluate the diagnostic utility of vegetative versus psychological symptoms for identifying depression in this population.
Main Methods:
- A cohort of 124 patients with ESRD undergoing maintenance hemodialysis was assessed.
- Depression diagnosis was established using the Research Diagnostic Criteria (RDC).
- The discriminative value of vegetative and psychological depressive symptoms was analyzed.
Main Results:
- A prevalence of 17.7% for RDC-defined minor depression was observed.
- A prevalence of 6.5% for RDC-defined major depression was identified.
- Psychological symptoms (suicidal ideation, depressed mood, discouragement) were more effective discriminators of depression than vegetative symptoms.
Conclusions:
- Depression is a significant concern in ESRD patients on hemodialysis, with notable prevalence rates for both minor and major depression.
- Psychological symptoms are more reliable indicators of depression in ESRD patients compared to vegetative symptoms.
- Clinical assessment of depression in ESRD patients should prioritize the evaluation of psychological distress.