title: Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression.
abstract: Depressive symptoms, assessed using a self-report type of questionnaire, have been associated with poor outcomes in dialysis patients. Here we determined if depressive disorders diagnosed by physicians are also associated with such outcomes. Ninety-eight consecutive patients on chronic hemodialysis underwent the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders administered by a physician. Depression was diagnosed in about a quarter of the patients. Associations adjusted for age, gender, race, time on dialysis and co-morbidity were determined using survival analysis. Using time to event (death or hospitalization) models of analysis the hazard ratios were 2.11 and 2.07 in unadjusted and adjusted models respectively. The finding of poor outcome using a formal structured physician interview suggests that a prospective study is needed to determine whether treatment of depression affects clinical outcomes.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. susan.hedayati@utsouthwestern.edu
authors.forename: S Susan
authors.initials: SS
authors.lastname: Hedayati
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.forename: Libbie P
authors.initials: LP
authors.lastname: Briley
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Sloane
authors.forename: Carl F
authors.initials: CF
authors.lastname: Pieper
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.forename: Lynda A
authors.initials: LA
authors.lastname: Szczech
mesh_terms: D000328:Adult; D000368:Aged; D003643:Death; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality / Q000523:psychology*; D016019:Survival Analysis