Diagnosis of depression in patients with end-stage renal disease. Comparative analysis.

To evaluate the variability in the diagnosis of depression in patients receiving maintenance therapy for end-stage renal disease, a study of 60 randomly selected patients was conducted. Three representative depression assessment methods were employed concurrently in the evaluation of each patient: (1) a structured psychiatric interview based on the diagnostic criteria of the American Psychiatric Association (DSM-III); (2) the Beck Depression Inventory; and (3) the Multiple Affect Adjective Check List. Among the 60 patients, 47 percent were classified as depressed by the Beck Depression Inventory, whereas 17 percent and 5 percent were determined to be depressed according to the Multiple Affect Adjective Check List and DSM-III criteria, respectively. The data demonstrated these differences to be dependent on the overlap between the symptoms of uremia and depression, as well as on the duration of those symptoms. This study also suggests that death wish, suicidal intention, and other psychologic symptoms should receive particular attention in the clinical assessment of depression in patients with end-stage renal disease.