Death or Hospitalization of Patients on Chronic Hemodialysis Is Associated With a Physician-Based Diagnosis of Depression

Kidney Int. 2008 Oct;74(7):930-6. doi: 10.1038/ki.2008.311. Epub 2008 Jun 25.

Abstract

Depressive symptoms, assessed using a self-report type of questionnaire, have been associated with poor outcomes in dialysis patients. Here we determined if depressive disorders diagnosed by physicians are also associated with such outcomes. Ninety-eight consecutive patients on chronic hemodialysis underwent the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders administered by a physician. Depression was diagnosed in about a quarter of the patients. Associations adjusted for age, gender, race, time on dialysis and co-morbidity were determined using survival analysis. Using time to event (death or hospitalization) models of analysis the hazard ratios were 2.11 and 2.07 in unadjusted and adjusted models respectively. The finding of poor outcome using a formal structured physician interview suggests that a prospective study is needed to determine whether treatment of depression affects clinical outcomes.

MeSH terms

  • Adult
  • Aged
  • Death
  • Depressive Disorder* / complications
  • Depressive Disorder* / diagnosis
  • Depressive Disorder* / mortality
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Interviews as Topic
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / psychology*
  • Male
  • Middle Aged
  • Physicians
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Dialysis / mortality
  • Renal Dialysis / psychology*
  • Survival Analysis