Major depressive disorder in hemodialysis patients in China

Abstract

Introduction: Major depressive disorder (MDD) has been regarded as the most common psychiatric disorder among hemodialysis (HD) patients. However, few studies have investigated MDD in HD patients in Mainland China. This study sought to investigate the prevalence and treatment of MDD, as well as the sociodemographic and clinical characteristics in this population.

Methods: Two hundred sixty HD patients were screened with the nine-item Patient Health Questionnaire, and the formal diagnosis of MDD was further assessed using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Severity of depressive symptoms was assessed with Hamilton Rating Scale for Depression. Finally, patients meeting diagnostic criteria were compared with those who did not on demographic and clinical characteristics.

Results: Among the 260 subjects, 26.2% screened positively and 10% were confirmed to have a diagnosis of MDD. Among HD patients with MDD, 69.2% had severe or very severe depressive symptoms. There was no evidence of a clinical diagnosis or of treatment for MDD in any of the patients' medical records. Those with shorter duration of HD, lower monthly income, and lower levels of blood urea nitrogen were significantly more likely to have a diagnosis of MDD.

Discussion: MDD is frequent in HD patients. Regular screening and professional diagnosis should be undertaken to increase the detection and treatment of MDD in HD patients. The effectiveness of interventions for MDD in HD patients deserves further research.

Keywords: China; comorbidity; hemodialysis; major depressive disorder; prevalence.