Internal Medicine and Nephrology, University of Jordan School of Medicine, Amman, Jordan.
Deanship of Research, University of Jordan, Amman, Jordan.
Int J Psychiatry Med. 2021 Nov;56(6):433-445. doi: 10.1177/0091217420973489. Epub 2020 Nov 8.
An overlap between the somatic symptoms of depression and those of uremia seen in end-stage renal disease (ESRD) patients may affect the diagnosis of depression. This study aims to evaluate the effect of hemodialysis on the diagnosis of depression among patients on maintenance hemodialysis as dialysis diminishes the uremic symptoms, and to compare depression scores before and after dialysis.
This was a cross-sectional analytic study conducted from November 2018 through April 2019, in three tertiary hospitals. Consenting participants aged 18 years or older, who had received hemodialysis for at least three months were included. The Patient Health Questionnaire (PHQ-9) tool was used to collect patients' data and to identify symptoms of depression Pre- and post-hemodialysis. Depression scores were compared using the paired sample Wilcoxon rank test or the McNemar test, where appropriate.
Overall, 163 participants were enrolled in the study. The average age of the participants was 56.5 years old, whereas 44.8% were females. The prevalence of depressive symptoms before hemodialysis was 48.5%, with prevalence of mild, moderate and moderately severe of 34.4%, 11.7% and 2.5%, respectively. On the other hand, the prevalence of depressive symptoms after hemodialysis was 46.6% with 36.8%, 9.2% and 0.6% of the participants reporting mild, moderate and moderately severe symptoms, respectively. We found no significant difference in depression scores before and after dialysis (p-values > 0.05).
Our study supports the fact that the prevalence of depression is high among patients with ESRD on maintenance hemodialysis. We didn't find a significant difference in depression scores among hemodialysis patients before and after dialysis, with negligible effect of uremic symptoms on the diagnosis of depression. We suggest adopting routine screening of depression among this high-risk group of patients.
终末期肾病（ESRD）患者的躯体症状与尿毒症之间存在重叠，这可能会影响抑郁症的诊断。本研究旨在评估血液透析对维持性血液透析患者抑郁症诊断的影响，因为透析可减轻尿毒症症状，并比较透析前后的抑郁评分。
这是一项横断面分析研究，于 2018 年 11 月至 2019 年 4 月在三家三级医院进行。纳入同意参加研究且年龄在 18 岁或以上、接受血液透析至少三个月的患者。使用患者健康问卷（PHQ-9）工具收集患者数据，并在血液透析前后识别抑郁症状。使用配对样本 Wilcoxon 秩和检验或 Mcnemar 检验比较抑郁评分，在适当情况下使用。
共有 163 名参与者纳入研究。参与者的平均年龄为 56.5 岁，其中 44.8%为女性。血液透析前抑郁症状的患病率为 48.5%，轻度、中度和中度重度的患病率分别为 34.4%、11.7%和 2.5%。另一方面，血液透析后抑郁症状的患病率为 46.6%，轻度、中度和中度重度的患病率分别为 36.8%、9.2%和 0.6%。我们发现血液透析前后抑郁评分无显著差异（p 值均>0.05）。
我们的研究支持这样一个事实，即维持性血液透析的 ESRD 患者中抑郁的患病率很高。我们没有发现血液透析患者透析前后抑郁评分有显著差异，尿毒症症状对抑郁症的诊断影响可以忽略不计。我们建议对这一高危患者群体常规进行抑郁症筛查。
