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The diagnosis of major depression in end-stage renal disease
1Georgetown University Hospital, Department of Psychiatry, Washington, D.C. 20007, USA.
Background:
Although major depression commonly occurs in medically ill patients, it can be difficult to diagnose since depression and many medical illnesses share common physical symptoms.
Methods:
This study was designed to evaluate patients with end-stage renal disease (ESRD) for major depressive disorder using three diagnostic approaches, to assess the Beck Depression Inventory as a screening instrument for major depression, and to examine the association of anhedonia with a diagnosis of major depression in ESRD patients who deny depressed mood.
Results:
Rates of major depression varied from 6 to 34% according to the criteria that were used. The sensitivity of the Beck Depression Inventory was found to be modest. Anhedonia was a helpful clue for diagnosing depression in patients who denied depressed mood.
Conclusions:
The findings illustrate the current difficulties in applying DSM criteria for major depression to medical patients and underscore the need for more specific guidelines.