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Depression and Associated Factors in Chinese Patients With Chronic Kidney Disease Without Dialysis: A Cross-Sectional
Difei Duan1,2,3, Lin Yang2, Min Zhang1
1Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China.
Insights
Depression is common in Chinese patients with chronic kidney disease (CKD) without dialysis. Negative illness perception, low self-esteem, and pain interference are key factors associated with depression in this population.
Area of Science:
- Nephrology
- Psychiatry
- Public Health
Background:
- Chronic kidney disease (CKD) is a significant global health concern.
- Depression is prevalent in CKD patients and linked to adverse outcomes.
- Understanding factors contributing to depression in non-dialysis CKD patients is crucial.
Purpose of the Study:
- To determine the prevalence of depression in Chinese CKD patients not on dialysis.
- To explore the relationships between illness perception, self-esteem, pain interference, and depression.
Main Methods:
- A cross-sectional study involving 334 CKD patients.
- Depression assessed using the Beck Depression Inventory-II (BDI-II).
- Illness perception, self-esteem, and pain interference measured via questionnaires; structural equation modeling (SEM) used for analysis.
Main Results:
- The prevalence of depression was 22.2% among the study participants.
- Negative illness perception and low self-esteem showed a moderate association with depression.
- Pain interference had a weaker association with depression.
Conclusions:
- Negative illness perception, low self-esteem, and severe pain interference are associated with depression in Chinese CKD patients without dialysis.
- Further research is needed to elucidate mechanisms and develop interventions for this vulnerable group.
Abstract:
Background: Chronic kidney disease (CKD) has been a globally public health problem over the past decades. The maintenance of physical and mental health is of importance for patients nowadays. Notably, depression is prevalent and associated with various adverse events in CKD patients without dialysis. Prior studies have reported that pain, negative illness perception, pain, and low self-esteem are potential risk factors of depression, while few studies have comprehensively investigated the mechanisms among these factors and depression among this population. Purpose: This study aims to investigate the prevalence of depression and further explore the factors associated with depression among CKD patients without dialysis in China. Design and Methods: We conducted a cross-sectional study in patients with diagnosed CKD to investigate the prevalence of depression was by the Beck Depression Inventory-II (BDI-II). The data on pain interference, illness perception, and self-esteem were also collected via self-administered questionnaires. A structural equation model (SEM) was used to examine the factors associated with depression. Main Findings: From June to October 2019, we successfully interviewed 334 CKD patients at the outpatient clinics. Their mean age was 45.6 years (ranging from 19 to 74 years), and 48.5% were male. Most respondents were at early CKD stages (77.5% stage 1-3) and the prevalence of depression was 22.2%. We found a moderate association between illness perception and depression, which was modified by self-esteem. Similar but weaker association was found between pain interference and depression. Conclusion and Recommendations: Negative illness perception, low self-esteem and severe pain interference were associated with depression among Chinese CKD patients without dialysis. Future studies are warranted to investigate the underlying mechanism and formulate the intervention strategies for this high-risk population.
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