Duarte Priscila Silveira, Miyazaki Maria Cristina, Blay Sergio Luís, Sesso Ricardo
Department of Medicine, Division of Nephrology, Federal University of São Paulo, Sao Paulo, Brazil.
Kidney Int. 2009 Aug;76(4):414-21. doi: 10.1038/ki.2009.156. Epub 2009 May 20.
Depression is an important target of psychological assessment in patients with end-stage renal disease because it predicts their morbidity, mortality, and quality of life. We assessed the effectiveness of cognitive-behavioral therapy in chronic hemodialysis patients diagnosed with major depression by the Mini International Neuropsychiatric Interview (MINI). In a randomized trial conducted in Brazil, an intervention group of 41 patients was given 12 weekly sessions of cognitive-behavioral group therapy led by a trained psychologist over 3 months while a control group of 44 patients received the usual treatment offered in the dialysis unit. In both groups, the Beck Depression Inventory, the MINI, and the Kidney Disease and Quality of Life-Short Form questionnaires were administered at baseline, after 3 months of intervention or usual treatment, and after 9 months of follow-up. The intervention group had significant improvements, compared to the control group, in the average scores of the Beck Depression Inventory overall scale, MINI scores, and in quality-of-life dimensions that included the burden of renal disease, sleep, quality of social interaction, overall health, and the mental component summary. We conclude that cognitive-behavioral group therapy is an effective treatment of depression in chronic hemodialysis patients.
抑郁症是终末期肾病患者心理评估的重要目标，因为它能预测患者的发病率、死亡率和生活质量。我们通过迷你国际神经精神访谈（MINI）评估了认知行为疗法对诊断为重度抑郁症的慢性血液透析患者的疗效。在巴西进行的一项随机试验中，41名患者的干预组在3个月内由一名经过培训的心理学家进行了为期12周的认知行为团体治疗，而44名患者的对照组接受了透析单位提供的常规治疗。在两组中，贝克抑郁量表、MINI以及肾病与生活质量简表问卷在基线、干预或常规治疗3个月后以及随访9个月后进行了评估。与对照组相比，干预组在贝克抑郁量表总分平均得分、MINI得分以及包括肾病负担、睡眠、社会交往质量、总体健康和心理成分总结在内的生活质量维度方面有显著改善。我们得出结论，认知行为团体治疗是慢性血液透析患者抑郁症的有效治疗方法。
