University of the West Indies, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago.
San Fernando General Hospital, Chancery Lane, San Fernando, Trinidad and Tobago.
BMC Psychiatry. 2023 Oct 10;23(1):733. doi: 10.1186/s12888-023-05249-y.
Depression with diverse etiologies is exacerbated by chronic diseases, such as chronic kidney disease (CKD), coronary artery disease (CAD), cancer, diabetes mellitus, and hypertension. This study aimed to analyse depression, its associations, and predictors among patients attending the kidney clinic of a teaching hospital.
Data were collected from 01 August 2017 to 30 September 2017 via face-to-face interviews and examination of the medical records of a convenience sample of 314 patients. The patients were categorised broadly as stages I and II with an estimated glomerular filtration rate (eGFR) > 60 mls/min/1.73 m, and with stages III, IV, and V or GFR ≤ 60 mls/ min/1.73 m (or CKD). The Patient Health Questionnaire (PHQ)-9 was the data collection instrument for depression-related data.
Participants were predominantly male (n = 179; 57.0%), aged over 60 years (n = 211; 67.2%), Indo-Trinbagonian (n = 237; 75.5%), and with stages III, IV, and V CKD. The two leading comorbid conditions were hypertension (83.4%) and diabetes mellitus (56.1%). Of the 261 (83.1%) patients with recorded eGFR, 113 (43.3%) had Stage III CKD. The mean depression (PHQ-9) score was 13.0/27 (±9.15), with 306 (97.5%) patients diagnosed as having depression with the following severities: mild (n = 116; 37.9%), moderate (n = 138, 45.1%), moderately severe (n = 38; 12.4%), and severe (n = 14; 4.6%). Depression was independent of sex. Nine sociodemographic variables were associated with depression; however, 'level of education', was the only predictor of depression with greater severity associated with lower levels of education. eGFR was negatively correlated with the PHQ-9 scores (Pearson's correlation, r = -0.144, p = 0.022). At least 78.3% of the patients who self-reported no depression had clinical depression (moderate, moderately severe, or severe) PHQ-9 scores ≥ 10.
Depression was a significant comorbidity among patients with CKD, with the majority displaying clinical depression. "Level of education" was the only predictor of depression. Self-reported depression is an unreliable method for evaluating clinical depression.
慢性疾病，如慢性肾脏病（CKD）、冠状动脉疾病（CAD）、癌症、糖尿病和高血压，会使各种病因引起的抑郁症恶化。本研究旨在分析在教学医院肾脏诊所就诊的患者中抑郁、其关联和预测因素。
2017 年 8 月 1 日至 9 月 30 日期间，通过面对面访谈和对 314 名方便样本患者的病历进行检查，收集数据。患者被分为 I 期和 II 期，估计肾小球滤过率（eGFR）>60ml/min/1.73m，III、IV 和 V 期或 GFR≤60ml/min/1.73m（或 CKD）。患者健康问卷（PHQ-9）是用于收集与抑郁相关数据的工具。
参与者主要为男性（n=179；57.0%）、年龄超过 60 岁（n=211；67.2%）、印度-特立尼达和多巴哥裔（n=237；75.5%）和 III、IV 和 V 期 CKD。两种主要的合并症是高血压（83.4%）和糖尿病（56.1%）。在 261 名（83.1%）有记录的 eGFR 的患者中，有 113 名（43.3%）患有 III 期 CKD。抑郁（PHQ-9）评分的平均（±9.15）得分为 13.0/27，306 名（97.5%）患者被诊断为患有抑郁症，其严重程度如下：轻度（n=116；37.9%）、中度（n=138，45.1%）、中度严重（n=38；12.4%）和严重（n=14；4.6%）。抑郁与性别无关。9 个社会人口统计学变量与抑郁相关；然而，“教育程度”是与抑郁严重程度相关的唯一预测因素，与较低的教育程度相关。eGFR 与 PHQ-9 评分呈负相关（皮尔逊相关，r=-0.144，p=0.022）。至少 78.3%自我报告无抑郁的患者 PHQ-9 评分≥10，存在临床抑郁（中度、中度严重或严重）。
抑郁是 CKD 患者的一种重要合并症，大多数患者都有临床抑郁。“教育程度”是唯一预测抑郁的因素。自我报告的抑郁是评估临床抑郁的不可靠方法。
