Depression and Suicide Risk in Hemodialysis Patients With Chronic Renal Failure
Received June 17, 2010; revised July 15, 2010; accepted July 16, 2010. From the Dept. of Psychiatry and Nephrology, Chang Gung Memorial Hospital at Keelung, Taiwan; Chang Gung University School of Medicine, Taiwan; Division of Mental Health and Drug Abuse Research, National Health Research Institute, Miaoli, Taiwan; and the Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan. Send correspondence and reprint requests to Liang-Jen Wang, M.D., Dept. of Psychiatry, Chang Gung Memorial Hospital at Keelung. No. 200 Ave 208 Chi-Chin-Yi Rd., Keelung, Taiwan. e-mail: WangLiangJen@gmail.com
sychosomatics 51:528-5286, November-December 2010
doi: 10.1176/appi.psy.51.6.528
© 2010 Academy of Psychosomatic Medicine© 2010 The Academy of Psychosomatic Medicine
Abstract
BACKGROUND: Depression and suicide are well established as prevalent mental health problems for patients on hemodialysis.
OBJECTIVE: The authors examined the demographic and psychological factors associated with depression among hemodialysis patients and elucidated the relationships between depression, anxiety, fatigue, poor health-related quality of life, and increased suicide risk.
METHOD: This cross-sectional study enrolled 200 end-stage renal disease patients age
18 years on hemodialysis. Psychological characteristics were assessed with the Mini-International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale, the short-form Health-Related Quality of Life Scale, and Chalder Fatigue Scale, and structural equation modeling was used to analyze the models and the strength of relationships between variables and suicidal ideation.
RESULTS: Of the 200 patients, 70 (35.0%) had depression symptoms, and 43 (21.5%) had had suicidal ideation in the previous month. Depression was significantly correlated with a low body mass index (BMI) and the number of comorbid physical illnesses. Depressed patients had greater levels of fatigue and anxiety, more common suicidal ideation, and poorer quality of life than nondepressed patients. Results revealed a significant direct effect for depression and anxiety on suicidal ideation.
CONCLUSION: Among hemodialysis patients, depression was associated with a low BMI and an increased number of comorbid physical illnesses. Depression and anxiety were robust indicators of suicidal ideation. A prospective study would prove helpful in determining whether early detection and early intervention of comorbid depressionand anxiety among hemodialysis patients would reduce suicide risk.
Read full article here
sychosomatics 51:528-5286, November-December 2010
doi: 10.1176/appi.psy.51.6.528
© 2010 Academy of Psychosomatic Medicine© 2010 The Academy of Psychosomatic Medicine
Abstract
BACKGROUND: Depression and suicide are well established as prevalent mental health problems for patients on hemodialysis.
OBJECTIVE: The authors examined the demographic and psychological factors associated with depression among hemodialysis patients and elucidated the relationships between depression, anxiety, fatigue, poor health-related quality of life, and increased suicide risk.
METHOD: This cross-sectional study enrolled 200 end-stage renal disease patients age
18 years on hemodialysis. Psychological characteristics were assessed with the Mini-International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale, the short-form Health-Related Quality of Life Scale, and Chalder Fatigue Scale, and structural equation modeling was used to analyze the models and the strength of relationships between variables and suicidal ideation. RESULTS: Of the 200 patients, 70 (35.0%) had depression symptoms, and 43 (21.5%) had had suicidal ideation in the previous month. Depression was significantly correlated with a low body mass index (BMI) and the number of comorbid physical illnesses. Depressed patients had greater levels of fatigue and anxiety, more common suicidal ideation, and poorer quality of life than nondepressed patients. Results revealed a significant direct effect for depression and anxiety on suicidal ideation.
CONCLUSION: Among hemodialysis patients, depression was associated with a low BMI and an increased number of comorbid physical illnesses. Depression and anxiety were robust indicators of suicidal ideation. A prospective study would prove helpful in determining whether early detection and early intervention of comorbid depressionand anxiety among hemodialysis patients would reduce suicide risk.
Read full article here
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