Development and Preliminary Validation of a Depression Assessment Tool for Maintenance Hemodialysis Patients

Ther Apher Dial. 2019 Feb;23(1):49-58. doi: 10.1111/1744-9987.12749. Epub 2018 Sep 21.


Patients undergoing maintenance hemodialysis (MHD) are subject to a higher-than-usual prevalence of depressive disorders. However, the lack of consensus regarding the best assessment method remains an important problem. Thus, there is a clear need for more effective screening tools and an easily administered, disease-specific self-report measure of depression in MHD patients. After we developed and administered an initial depression inventory for MHD patients (I-DI-MHD), we created the DI-MHD and administered the DI-MHD and the Beck Depression Inventory (BDI) to 354 patients from four hospitals. Reliability, construct validity and receiver operator characteristic curves were assessed. The 17-item DI-MHD instrument displayed good internal consistency (Cronbach's alpha =0.893), provided excellent convergent validity, and correlated with the BDI scale (kappa =0.785, P <0.001). A factor analysis pattern matrix analysis showed that a four-factor model provided the best account of the data. Finally, the DI-MHD cutoff yielded a sensitivity of 0.97 and a specificity of 0.86, which were slightly better than the corresponding values for the BDI. The DI-MHD scale shows reasonable validity and reliability for assessing depression in MHD patients.

Keywords: Beck Depression Inventory; Depression; Maintenance hemodialysis; Screening instrument.

MeSH terms

  • Aged
  • China / epidemiology
  • Depression* / diagnosis
  • Depression* / epidemiology
  • Depression* / physiopathology
  • Depression* / prevention & control
  • Female
  • Humans
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / psychology
  • Kidney Failure, Chronic* / therapy
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Patient Health Questionnaire
  • Prevalence
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / methods
  • Renal Dialysis* / psychology
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires