Source
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY 11203-2098, USA. Daniel.Cukor@Downstate.edu
Abstract
BACKGROUND AND OBJECTIVES:
There is growing identification of the need to seriously study the psychiatric presentations of end-stage renal disease patients treated with hemodialysis. This study reports on the course of depression and anxiety diagnoses and their impact on quality of life and health status.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:
The 16-mo course of psychiatric diagnoses in 50 end-stage renal disease patients treated with hemodialysis was measured by structured clinical interview.
RESULTS:
Three different pathways were identified: one subset of patients not having a psychiatric diagnosis at either baseline or 16-mo follow-up (68% for depression, 51% for anxiety), one group having an intermittent course (21% for depression, 34% for anxiety), and one group having a persistent course (11% for depression, 15% for anxiety),
with diagnoses at both time 1 and time 2. For depression, the people
with the persistent course showed marked decreases in quality of life
and self-reported health status compared with the nondepressed and
intermittently depressed cohorts. The most powerful predictor of
depression at time 2 is degree of depressive affect at time 1(P <
0.05).
CONCLUSIONS:
Patients
at risk for short- and long-term complications of depression can be
potentially identified by high levels of depressive affect even at a
single time point. As nearly 20% of the sample had chronic depression or
anxiety, identifying a psychiatric diagnosis in hemodialysis patients
and then offering treatment are important because, in the absence of
intervention, psychiatric disorders are likely to persist in a
substantial proportion of patients.
- PMID:
- 18684897
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC2572273
- http://www.ncbi.nlm.nih.gov/pubmed/18684897
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