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Comparative Study
. 2009 Sep;54(3):424-32.
doi: 10.1053/j.ajkd.2009.03.017. Epub 2009 Jun 3.

Prevalence of major depressive episode in CKD

S Susan Hedayati  1 , Abu T Minhajuddin, Robert D Toto, David W Morris, A John Rush
Affiliations
Comparative Study

Prevalence of major depressive episode in CKD

S Susan Hedayati et al. Am J Kidney Dis. 2009 Sep.

Abstract

Background: Depression is prevalent in long-term dialysis patients and is associated with death and hospitalization. Whether depression is present through all chronic kidney disease (CKD) stages or appears after dialysis therapy initiation is not clear. We determined the prevalence of a major depressive episode and other psychiatric illnesses by using a structured gold-standard clinical interview and demographic and clinical variables associated with major depressive episode in patients with CKD.

Study design: Observational cross-sectional study using a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based structured interview administered by trained persons to 272 consecutive participants. Multivariable logistic regression was used to determine demographic and clinical variables associated with major depressive episode.

Setting & participants: Patients with stages 2 to 5 CKD not treated by using dialysis were consecutively approached and enrolled from a Veterans Affairs CKD clinic.

Predictors: Demographic and clinical variables.

Outcome: Major depressive episode diagnosed by using a structured Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based interview, the Mini International Neuropsychiatric Interview.

Results: The cohort had a mean age of 64.5 +/- 12.0 years. Thirty-eight percent were African American, and 55% had diabetes mellitus. Percentages of patients with stages 2, 3, 4, and 5 CKD were 6%, 38%, 41%, and 14%, respectively. Mean hemoglobin level was 12.5 +/- 2.0 g/dL. The prevalence of a major depressive episode was 21% and did not vary significantly among different CKD stages. Variables associated with a major depressive episode were diabetes mellitus, comorbid psychiatric illness, and history of drug or alcohol abuse.

Limitations: Single-center study composed of primarily male veterans.

Conclusions: One in 5 patients with CKD had a major depressive episode. Patients with CKD should be screened routinely for depression given this high prevalence and the independent association of depression with poor outcomes in patients with end-stage renal disease receiving maintenance dialysis.

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Figures

Figure 1
Figure 1
Participant distribution by deciles of estimated glomerular filtration rate (eGFR). GFR was estimated by using the 4-variable Modification of Diet in Renal Disease Study equation.
See this image and copyright information in PMC

Comment in

References

    1. Hedayati SS, Bosworth HB, Kuchibhatla M, Kimmel PL, Szczech LA. The predictive value of self-report scales compared with physician diagnosis of depression in hemodialysis patients. Kidney Int. 2006;69:1662–1668. - PubMed
    1. Watnick S, Wang PL, Demadura T, Ganzini L. Validation of 2 depression screening tools in dialysis patients. Am J Kidney Dis. 2005;46:919–924. - PubMed
    1. Craven JL, Rodin GM, Littlefield C. The BDI as a screening device for major depression in renal dialysis patients. Int J Psychiatry Med. 1988;18:365–374. - PubMed
    1. Watnick S, Kirwin P, Mahnensmith R, Concato J. The prevalence and treatment of depression among patients starting dialysis. Am J Kidney Dis. 2003;41:105–110. - PubMed
    1. Lopes AA, Albert JM, Young EW, et al. Screening for depression in hemodialysis patients: Associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int. 2004;66:2047–2053. - PubMed

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