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Prevalence of Major Depressive Episode in CKD
Open accessAbstract
Background Depression is prevalent in long-term dialysis patients and is associated with death and hospitalization. Whether depression is present through all chronic kidney disease (CKD) stages or appears after dialysis therapy initiation is not clear. We determined the prevalence of a major depressive episode and other psychiatric illnesses by using a structured gold-standard clinical interview and demographic and clinical variables associated with major depressive episode in patients with CKD.Study design Observational cross-sectional study using a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based structured interview administered by trained persons to 272 consecutive participants. Multivariable logistic regression was used to determine demographic and clinical variables associated with major depressive episode.Setting & participants Patients with stages 2 to 5 CKD not treated by using dialysis were consecutively approached and enrolled from a Veterans Affairs CKD clinic.Predictors Demographic and clinical variables.Outcome Major depressive episode diagnosed by using a structured Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based interview, the Mini International Neuropsychiatric Interview.Results The cohort had a mean age of 64.5 +/- 12.0 years. Thirty-eight percent were African American, and 55% had diabetes mellitus. Percentages of patients with stages 2, 3, 4, and 5 CKD were 6%, 38%, 41%, and 14%, respectively. Mean hemoglobin level was 12.5 +/- 2.0 g/dL. The prevalence of a major depressive episode was 21% and did not vary significantly among different CKD stages. Variables associated with a major depressive episode were diabetes mellitus, comorbid psychiatric illness, and history of drug or alcohol abuse.Limitations Single-center study composed of primarily male veterans.Conclusions One in 5 patients with CKD had a major depressive episode. Patients with CKD should be screened routinely for depression given this high prevalence and the independent association of depression with poor outcomes in patients with end-stage renal disease receiving maintenance dialysis.
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“Half of all hemodialysis patients report pain symptoms, which are often inadequately controlled with medication [15,16].”
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Metadata
- Authors
- Hedayati, S. S., Minhajuddin, A. T., Toto, R. D., Morris, D. W., & Rush, A. J.
- Affiliations
- VA North Texas Health Care System (US)
- The University of Texas Southwestern Medical Center (US)
- National University of Singapore (SG)
- Corresponding author
- Hedayati, S. Susan
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2009-09
- Volume
- 54
- Issue
- 3
- Pages
- 424-432
- ISSN
- 0272-6386 (ISSN-L)
- PMC
- PMC3210064
- OpenAlex
- W2102774835
- Cited by
- 205
- References
- 53
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 10 · 2023: 8 · 2022: 12 · 2021: 13 · 2020: 16 · 2019: 14 · 2018: 8 · 2017: 11 · 2016: 12 · 2015: 5 · 2014: 13 · 2013: 12 · 2012: 16
- FWCI
- 11.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Society of Nephrology
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK002818, 2K24DK002818-0, P30DK079328)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- major depressive episode, chronic kidney disease, depression prevalence, psychiatric comorbidity, diabetes mellitus, alcohol and drug abuse, end-stage renal disease, veterans, depression screening, risk factors for depression
- MeSH terms
- Aged, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Interview, Psychological, Kidney Failure, Chronic, Male, Middle Aged, Risk Factors, Cohort Studies, Prevalence
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