Meram School of Medicine, Selcuk University, Hemodiyaliz Sekreterligi, Meram, Konya, Turkey.
Int Urol Nephrol. 2010 Jun;42(2):527-36. doi: 10.1007/s11255-009-9686-y. Epub 2009 Dec 2.
There is scarce data about effects of treatment of clinical depression in peritoneal dialysis (PD) population. We aimed to determine prevalence of depression, its association with health-related quality of life (HRQoL) and effects of sertraline treatment in PD patients.
We included 124 PD patients who had been on PD at least for 6 months. Short Form of Medical Outcomes Study was used to evaluate HRQoL. Depression was screened by Beck Depression Inventory (BDI). Patients with a BDI score > or = 17 were deemed to have depression and were referred to a psychiatrist for evaluation via Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) of diagnosis of clinical depression. About 25 patients diagnosed with clinical depression agreed to receive antidepressant treatment (Sertraline hydrochloride, 50 mg/day) for a 12-week period. After the treatment, biochemical analyses and questionnaires were repeated.
Thirty-two patients (25.8%) had depression. BDI score of patients were lower compared to those without depressive symptoms (23 + or - 6.7 and 9.8 + or - 3.0, respectively P < 0.001). Physical component scale (PCS) and mental component scale (MCS) domains of HRQoL were significantly decreased in patients with depression than in patients without depression (P < 0.001 for PCS and MCS). In bivariate analysis the BDI score was correlated inversely with the PCS and MCS (P < 0.001). Sertraline treatment improved BDI score of patients with depression (P < 0.001). HRQoL parameters also improved. No adverse effects requiring drug cessation was seen in the study group.
Treatment of depression with sertraline is associated with improvement of the HRQoL and symptoms related to depression.
关于治疗腹膜透析（PD）患者临床抑郁症的效果，相关数据十分匮乏。我们旨在确定抑郁的发生率，以及它与健康相关生活质量（HRQoL）的关系，并评估在 PD 患者中使用舍曲林治疗的效果。
我们纳入了 124 名 PD 患者，他们的 PD 治疗至少持续了 6 个月。使用健康调查简表（SF-36）评估 HRQoL。使用贝克抑郁量表（BDI）筛查抑郁。BDI 评分＞或＝17 分的患者被认为患有抑郁，并由精神科医生根据《精神障碍诊断与统计手册》（DSM-IV）进行临床抑郁症的诊断评估。约 25 名被诊断为临床抑郁症的患者同意接受为期 12 周的抗抑郁治疗（盐酸舍曲林，50mg/天）。治疗后，重复进行生化分析和问卷调查。
32 名患者（25.8%）患有抑郁症。与无抑郁症状的患者相比，BDI 评分较低（分别为 23 ± 6.7 和 9.8 ± 3.0，P ＜0.001）。与无抑郁症状的患者相比，患有抑郁症的患者 HRQoL 的生理成分量表（PCS）和心理成分量表（MCS）得分显著降低（PCS 和 MCS 的 P 值均＜0.001）。在双变量分析中，BDI 评分与 PCS 和 MCS 呈负相关（PCS 和 MCS 的 P 值均＜0.001）。舍曲林治疗改善了抑郁患者的 BDI 评分（P ＜0.001）。HRQoL 也有所改善。研究组未发现需要停药的不良反应。
舍曲林治疗抑郁与改善抑郁相关的 HRQoL 和症状相关。
