Domain-specific depression patterns among hemodialysis patients in Yemen: implications for mental-health screening in...

Depressive symptoms are common among patients with renal disease and are associated with poorer outcomes. This study examined depressive symptom dimensions (somatic vs. cognitive-affective) among hemodialysis patients and aimed to determine whether socioeconomic and clinical factors were differentially associated with these domains. A cross-sectional study was conducted in two major hemodialysis centers in Sana'a city between June and September 2025. Adult patients receiving maintenance hemodialysis completed the Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression analyses were conducted to identify factors independently associated with depressive symptoms. Of the 308 participants (56.8% male), 67.2% had PHQ-9 scores ≥10, indicating moderate-to-severe depressive symptoms. Low monthly household income was independently associated with higher odds of depressive symptoms (AOR 2.18; 95% CI 1.06-4.47; p = 0.032). Female sex (p = 0.076) and the presence of comorbidities (p = 0.052) showed borderline associations with depressive symptoms. The absence of medical insurance was associated with lower odds of depressive symptoms (AOR 0.46; 95% CI 0.26-0.81; p = 0.008), although this finding should be interpreted with caution. Low income and multimorbidity were associated with somatic symptoms, whereas smoking status and income were associated with cognitive-affective symptoms. Depressive symptoms were highly prevalent among hemodialysis patients in Sana'a, highlighting the need to integrate mental-health screening into dialysis care. Reducing financial barriers to treatment should also be prioritized in dialysis care settings in Sana'a and similar resource-limited settings.