title: Depressive symptoms predict the future risk of severe pruritus in haemodialysis patients: Japan Dialysis Outcomes and Practice Patterns Study.
abstract: BACKGROUND
  Recent reports suggest a cross-sectional association between psychiatric distress and pruritus in patients on haemodialysis (HD). However, no study has examined the likelihood of developing severe pruritus in patients on HD with depressive symptoms.
  
  
  OBJECTIVE
  To evaluate the relationship between baseline depressive symptoms and subsequent risk of developing severe pruritus.
  
  
  METHODS
  A longitudinal study with a 0.5-2.5-year follow-up period was performed using 1799 patients on HD who had no/mild pruritus at baseline, based on the Japan Dialysis Outcomes and Practice Patterns Study (1996-2004), a cohort study composed of a representative sample of patients on HD. We assessed pruritus after the follow-up period using a self-reported questionnaire and depressive symptoms using scores from the five-item version of the Mental Health Inventory (MHI-5).
  
  
  RESULTS
  The 1799 patients had a mean age of 56.9 years, 59.5% were men, and 23.6% presented depressive symptoms. Multivariable analysis revealed that patients with depressive symptoms had significantly higher odds of developing severe pruritus during the 0.5-2.5-year follow-up period [adjusted odds ratio (AOR) 1.57, 95% confidence interval 1.22-2.01, P < 0.001]. In addition, a significant linear trend was observed between baseline MHI-5 scores and risk of developing severe pruritus, with AORs for third, second and first MHI-5 score quartiles of 1.08, 1.51 and 1.95, respectively (P for trend < 0.0001).
  
  
  CONCLUSIONS
  Our results suggest that depressive symptoms measured by MHI-5 may predict the future risk of developing severe pruritus in patients on HD.
authors.affiliation: Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan. yamamotoy2@gmail.com
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashino
authors.forename: S
authors.initials: S
authors.lastname: Yamazaki
authors.forename: T
authors.initials: T
authors.lastname: Akiba
authors.forename: T
authors.initials: T
authors.lastname: Akizawa
authors.forename: Y
authors.initials: Y
authors.lastname: Asano
authors.forename: A
authors.initials: A
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Kurokawa
authors.forename: Y
authors.initials: Y
authors.lastname: Miyachi
authors.forename: S
authors.initials: S
authors.lastname: Fukuhara
mesh_terms: D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011537:Pruritus / Q000209:etiology / Q000523:psychology*; D006435:Renal Dialysis / Q000009:adverse effects / Q000523:psychology*