Depression in patients treated with haemodialysis: a cross-sectional study

Abstract

Background: The increasing incidence of end-stage renal disease in the Palestinian population and the effect of the disease on the psychological status of the patient underlie the importance of increasing knowledge about the mental health status of patients with end-stage renal disease. The aim of this study was to estimate the prevalence of depression in Palestinian patients treated with haemodialysis and its correlation with patients' clinical characteristics, health-related quality of life (HRQoL), and adherence to medications.

Methods: In this cross-sectional study, we collected a convenience sample from ten haemodialysis centres in the West Bank, occupied Palestinian territory, over 3 months in 2015. The Beck Depression Inventory-II scale (BDI-II) was used to assess depression, the EuroQol-5 Dimension scale was used to assess HRQoL, and the Morisky Medication Adherance-8 scale was used to assess compliance. We used SPSS version 16.0 for all statistical analyses. The study was approved by the Institutional Review Board at the An-Najah National University. Informed verbal consent was obtained from the participants before the start of the study.

Findings: We interviewed 286 patients who were treated with haemodialysis. The mean age was 52·0 years (SD 14·3), and 172 (60%) patients were men. The median number of years of dialysis was 2 years (IQR 1-4). 209 (73%) patients had depression. Most participants were non-compliant with their drug regimens and had low HRQoL. High depression scores were associated with old age (p<0·0001), female sex (p=0·036), low income (p=0·041), living in rural areas or in a camp (p=0·032), not doing regular exercise (p<0·0001), unemployment (p<0·0001), having multiple comorbidities (p<0·0001), and low adherence to medications (p=0·0075). We found an inverse correlation between depression and HRQoL (p<0·0001).

Interpretation: This study is to our knowledge the first of its kind in the West Bank. The incidence of depression is higher than reported in other communities. Most patients treated with haemodialysis were moderately to severely depressed and had low HRQol. There is a need to provide for a patient's needs in term of psychologist interviews and pharmacological and non-pharmacological interventions.

Funding: None.