Hu Aimin, Xue Zhimin, Mwansisya Tumbwene E, Zhou An, Pu Weidan, Chen Xudong, Sun Meng, Wang Peng, Fan Hua, Wang Zheng, Ouyang Xuan, Liu Zhening, Rosenheck Robert
Institute of Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China; Department of Medicine, Jishou University, Jishou, China.
Asia Pac Psychiatry. 2015 Mar;7(1):78-84. doi: 10.1111/appy.12110. Epub 2013 Nov 21.
Major depressive disorder (MDD) has been regarded as the most common psychiatric disorder among hemodialysis (HD) patients. However, few studies have investigated MDD in HD patients in Mainland China. This study sought to investigate the prevalence and treatment of MDD, as well as the sociodemographic and clinical characteristics in this population.
Two hundred sixty HD patients were screened with the nine-item Patient Health Questionnaire, and the formal diagnosis of MDD was further assessed using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Severity of depressive symptoms was assessed with Hamilton Rating Scale for Depression. Finally, patients meeting diagnostic criteria were compared with those who did not on demographic and clinical characteristics.
Among the 260 subjects, 26.2% screened positively and 10% were confirmed to have a diagnosis of MDD. Among HD patients with MDD, 69.2% had severe or very severe depressive symptoms. There was no evidence of a clinical diagnosis or of treatment for MDD in any of the patients' medical records. Those with shorter duration of HD, lower monthly income, and lower levels of blood urea nitrogen were significantly more likely to have a diagnosis of MDD.
MDD is frequent in HD patients. Regular screening and professional diagnosis should be undertaken to increase the detection and treatment of MDD in HD patients. The effectiveness of interventions for MDD in HD patients deserves further research.
重度抑郁症（MDD）被认为是血液透析（HD）患者中最常见的精神疾病。然而，在中国内地，很少有研究调查HD患者中的MDD情况。本研究旨在调查该人群中MDD的患病率和治疗情况，以及社会人口学和临床特征。
使用九项患者健康问卷对260名HD患者进行筛查，并使用《精神疾病诊断与统计手册》第四版进一步评估MDD的正式诊断。用汉密尔顿抑郁量表评估抑郁症状的严重程度。最后，将符合诊断标准的患者与不符合标准的患者在人口统计学和临床特征方面进行比较。
在260名受试者中，26.2%筛查呈阳性，10%被确诊患有MDD。在患有MDD的HD患者中，69.2%有严重或非常严重的抑郁症状。在任何患者的病历中均未发现MDD的临床诊断或治疗证据。HD病程较短、月收入较低和血尿素氮水平较低的患者被诊断为MDD的可能性明显更高。
MDD在HD患者中很常见。应进行定期筛查和专业诊断，以提高HD患者中MDD的检出率和治疗率。HD患者中MDD干预措施的有效性值得进一步研究。
