Al Zaben Faten, Sehlo Mohammad Gamal, Khalifa Doaa Ahmed, Al Shohaib Saad, Shaheen Faisul, Alzaben Linda, Ahmad Rami Ghazi, Ashy Jafar Ayman, Felemban Reema Ghazi, Koenig Harold G
Psychiatry Division, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Int Urol Nephrol. 2015 Jun;47(6):1001-10. doi: 10.1007/s11255-015-0977-1. Epub 2015 Apr 22.
The purpose was to determine the short-term course of depression among dialysis patients in Saudi Arabia and identify baseline characteristics that may influence course.
Thirty-nine dialysis patients in Jeddah, SA, were identified with subthreshold, minor, or major depressive disorders using the Structured Clinical Interview for Depression (SCID) and followed up at 6 and 12 weeks using the Longitudinal Interview and Follow-up Evaluation (LIFE) schedule. Depressive symptoms were tracked using the Hamilton Depression Rating Scale (HDRS). Patient characteristics measured at baseline included demographic, psychosocial, physical health, and treatment factors.
Of the 20 patients with major or minor depressive disorder, eight (40 %) fully remitted by 6 weeks and an additional three patients remitted over the next 6 weeks, leaving 45 % with significant depressive symptoms persisting beyond 12 weeks. Subthreshold disorders followed a similar course (42 % with persistent symptoms). Few patients received treatment for depression. Those with more education, severe health problems, poorer psychological function, more severe depressive symptoms, or a family psychiatric history were less likely to remit. Similar factors predicted change in depressive symptoms assessed by HDRS, especially high medical co-morbidity, severe illness, and overall poor psychological functioning.
Nearly one-half of depressed dialysis patients in Saudi Arabia continue to have significant symptoms beyond 12 weeks of follow-up, few of whom were treated. Specific characteristics at baseline identify depressed dialysis patients at greater risk of persistent symptoms who need treatment.
本研究旨在确定沙特阿拉伯透析患者抑郁症的短期病程，并找出可能影响病程的基线特征。
采用抑郁症结构化临床访谈（SCID），在沙特阿拉伯吉达市识别出39名患有阈下、轻度或重度抑郁症的透析患者，并使用纵向访谈和随访评估（LIFE）时间表在6周和12周时进行随访。使用汉密尔顿抑郁量表（HDRS）追踪抑郁症状。在基线时测量的患者特征包括人口统计学、心理社会、身体健康和治疗因素。
在20名患有重度或轻度抑郁症的患者中，8名（40%）在6周时完全缓解，另有3名患者在接下来的6周内缓解，12周后仍有45%的患者存在明显的抑郁症状。阈下障碍的病程相似（42%有持续症状）。很少有患者接受抑郁症治疗。受教育程度较高、健康问题严重、心理功能较差、抑郁症状较严重或有家族精神病史的患者缓解的可能性较小。类似的因素预测了通过HDRS评估的抑郁症状变化，尤其是高医疗合并症、重病和整体心理功能较差。
沙特阿拉伯近一半的抑郁透析患者在随访12周后仍有明显症状，其中很少有人接受治疗。基线时的特定特征可识别出持续症状风险较高且需要治疗的抑郁透析患者。
