Depressive symptoms predict the subsequent risk of bodily pain in dialysis patients: Japan Dialysis Outcomes and Practice Patterns Study.
BACKGROUND
Bodily pain and psychiatric distress are common symptoms in patients with dialysis. However, the temporal relationships have not yet been investigated. Objective. To evaluate the longitudinal association between depressive symptoms and subsequent risk of developing severe bodily pain in dialysis patients. Design. Prospective cohort study.


METHODS
We assessed bodily pain using a self-reported questionnaire and depressive symptoms using scores from the short version of Center for Epidemiological Studies Depression Screening Index (CES-D) from 531 participants showing no/mild bodily pain at baseline, based on the Japan Dialysis Outcomes and Practice Patterns Study, a cohort study of hemodialysis patients. To evaluate the relationship between depressive symptoms and development of severe bodily pain, multivariable logistic regression analysis was performed.


RESULTS
The 531 patients had a mean age of 57.9 years, 61.4% were male, and 33.1% had depressive symptoms. Logistic regression analysis revealed that depressive symptoms at baseline were significantly associated with higher odds of developing severe bodily pain during a 0.5- to 2.5-year follow-up period (adjusted odds ratio [AOR] = 2.13, 95% confidence interval [CI]: 1.36-3.33, P = 0.001). Further, patients with higher CES-D scores were likely to develop severe bodily pain (AOR = 1.09, 95% CI: 1.04-1.15, P = 0.001).


CONCLUSIONS
Results of this study suggest that depressive symptoms measured by CES-D predict the future risk of developing severe bodily pain in dialysis patients.
Yamamoto
Yosuke
Y
Department of Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. yamamotoy2@gmail.com
Hayashino
Yasuaki
Y
Akiba
Takashi
T
Akizawa
Tadao
T
Asano
Yasushi
Y
Saito
Akira
A
Kurokawa
Kiyoshi
K
Fukuhara
Shunichi
S
D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D010147:Pain Measurement; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome