Depression and suicidal ideation in hemodialysis patients
Depression and suicidal ideation in hemodialysis patients
Aim: Depression and suicide are more common comorbidities in end-stage renal disease patients than in healthy populations, but suicide has rarely been studied. Our research aimed to evaluate the relation between depressive mood and suicidal ideation in hemodialysis cases. Materials and Methods: 112 hemodialysis patients were included in the study. The sociodemographic characteristics of the patients and the laboratory test results were obtained from the file records. Beck Depression Inventory (BDI) and Suicidal Ideation Scale (SIS) were administered through face-to-face interviews. Results: We enrolled 112 volunteer hemodialysis patients [female/male, 48/64; age 59.9±13.5 years; hemodialysis duration 36.5 months (6-291)]. We divided the cases into two groups based on their BDI scores as those with depressive mood (BDI score17, n= 47) (42%) and those without (BDI score < 17, n= 65) (58%). Of the cases with depression, 38 (68.1%) were female, and 15 were male (31.9%)( p < 0.001). While age, calcium, and SIS were higher in the depressive group than in the other group, serum albumin levels were lower. A positive correlation was found between BDI and SIS (r=0.216, p < 0.05). The suicide ideation scale was positively correlated with age (r=0.254, p < 0.001), BDI (r=0.231, p < 0.05), and hemoglobin level (r=0.194, p < 0.05), while it was negatively correlated with serum albumin level (r= -0.250, p < 0.001). In Multiple Logistic Regression analysis, gender (OR: 5.915, 95%CI [2.086-16.776], p < 0.001) and serum albumin level (OR: 0.021, 95%CI [0.003-0.149], p < 0.001) were determined as independent risk factors for depressive mood. However, in Multiple Logistic Regression analysis, there was no significant relationship between SIS score and depressive mood (OR: 1.070, 95%CI [0.937-1.221], p>0.05). Conclusion; Depression was higher in hemodialysis patients, and depressed patients had higher suicidal ideation. Depression had no increment effect on the suicide risk. We think it would be beneficial to consider suicidal ideation along with depression.
___
- Lopes AA, Bragg J, Young E et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney Int. 2002; 62: 199–207
- 2. Kimmel PL Peterson RA,Weihs KL, Simmens SJ, Alleyne S, Cruz I & Veis JH (2000) Multiple measurements of depression predict mortality in a longitudinal study of chronic hemodialysis outpatients. Kidney International 57, 2093–2098.
- 3. Chilcot J, Wellsted D, Da Silva-Gane M & Farrington K (2008) Depression on dialysis. Nephron. Clinical Practice 108, 256–264 4. Staff, WSD. Dorland’s illustrated medical dictionary. Philadelphia: WB Saunders, 1994. 999(1290): p. 1699.
- 5. Durkheim E & Simons J (1992) Suicide and fertility: a study of moral statistics. European Journal of Population 83, 175–197. 6. Kurella M, Kimmel PL, Young BS, et al: Suicide in the United States end-stage renal disease program. J Am Soc Nephrol 2005; 16:774–781.
- 7. B. Kalender, A. C. Ozdemir, E. Dervisoglu, O. Ozdemir: Quality of life in chronic kidney disease: effects of treatment modality, depression, malnutrition and Inflammation. Int J Clin Pract, April 2007, 61, 4, 569–576
- 8. Hisli N. Beck Depresyon Envanteri’nin geçerliligi üzerine bir çalısma. Psikoloji Dergisi 1998;6:118–22
- 9. Levine, S., R.u. Ancill, and A. Roberts, Assessment of suicide risk by computer-delivered self-rating questionnaire: preliminary findings. Acta Psychiatrica Scandinavica, 1989. 80(3): p. 216- 220.
- 10. Dilbaz, N., et al., Intihar düsüncesi ölçeginin geçerlilik ve güvenirligi. 31. Ulusal Psikiyatri Bilimler Kongresi Bilimsel Çalısma Kitabı, 1995: p. 40-41.
- 11. Cohen LM, Dobscha SK, Hails KC, et al: Depression and suicidal ideation in patients who discontinue the life-support treatment of dialysis. Psychosom Med 2002; 64:889–896
- 12. Chih-Ken Chen , Yi-Chieh Tsai, Heng-Jung Hsu,et al: Depression and suicide risk in hemodialysis patients with chronic renal failure Psychosomatics Nov-Dec 2010;51(6):528-528.e6. DOI: 10.1176/appi.psy.51.6.528
- 13. Kalantar-Zadeh K, Abbott KC, Salahudeen AK, et al: Survival advantages of obesity in dialysis patients. Am J Clin Nutr 2005; 81:543–554
- 14. Kutner NG, Brogan D, Hall WD, HaberM & Daniels DS (2000) Functional impairment, depression and life satisfaction among older hemodialysis patients and age-matched controls: a prospective study. Archives of PhysicalMedicine and Rehabilitation 81, 453–459
- 15. Kusek JW, Greene P, Wang SR, Beck G, West D, Jamerson K, Agodoa LY, Faulkner M & Level B (2002) Crosssectional study of health related quality of life in African Americans with chronic renal insufficiency: the African American Study of Kidney Disease and Hypertension Trial. American Journal of Kidney Diseases 39, 513–524.
- 16. Crosby, A. E., Han, B., Ortega, L. A., Parks, S. E., & Gfroerer, J. (2011). Suicidal thoughts and behaviors among adults aged C18 years–United States, 2008–2009. MMWR Surveillance Summaries, 60(13), 1–22
- 17. De Sousa, A. (2008). Psychiatric issues in renal failure and dialysis. Indian Journal of Nephrology, 18(2), 47–50.
- 18. Hackney, C. H., & Sanders, G. S. (2003). Religiosity and Mental Health: A Meta-Analysis of Recent Studies. Journal for the Scientific Study of Religion, 42(1), 43–55.
- 19. Chaaya, M., Sibai, A. M., Fayad, R., & El-Roueiheb, Z. (2007). Religiosity and depression in older people: Evidence from underprivileged refugee and non-refugee communities in Lebanon. Aging Mental Health, 11(1), 37–44
- 20. Unal S (2000) Depression and personality. Index of Affective Disorders 2, 72–76