title: Sociodemographic factors contribute to the depressive affect among African Americans with chronic kidney disease.
abstract: Depression is common in end-stage renal disease and is associated with poor quality of life and higher mortality; however, little is known about depressive affect in earlier stages of chronic kidney disease. To measure this in a risk group burdened with hypertension and kidney disease, we conducted a cross-sectional analysis of individuals at enrollment in the African American Study of Kidney Disease and Hypertension Cohort Study. Depressive affect was assessed by the Beck Depression Inventory II and quality of life by the Medical Outcomes Study-Short Form and the Satisfaction with Life Scale. Beck Depression scores over 14 were deemed consistent with an increased depressive affect and linear regression analysis was used to identify factors associated with these scores. Among 628 subjects, 166 had scores over 14 but only 34 were prescribed antidepressants. The mean Beck Depression score of 11.0 varied with the estimated glomerular filtration rate (eGFR) from 10.7 (eGFR 50-60) to 16.0 (eGFR stage 5); however, there was no significant independent association between these. Unemployment, low income, and lower quality and satisfaction with life scale scores were independently and significantly associated with a higher Beck Depression score. Thus, our study shows that an increased depressive affect is highly prevalent in African Americans with chronic kidney disease, is infrequently treated with antidepressants, and is associated with poorer quality of life. Sociodemographic factors have especially strong associations with this increased depressive affect. Because this study was conducted in an African-American cohort, its findings may not be generalized to other ethnic groups.
authors.affiliation: Department of Medicine, Jesse Brown VA Medical Center and University of Illinois Medical Center, Chicago, Illinois, USA. fischerm@uic.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fischer
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.forename: Tom
authors.initials: T
authors.lastname: Greene
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Gassman
authors.forename: Xuelei
authors.initials: X
authors.lastname: Wang
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Brooks
authors.forename: Jeanne
authors.initials: J
authors.lastname: Charleston
authors.forename: Donna
authors.initials: D
authors.lastname: Dowie
authors.forename: Denyse
authors.initials: D
authors.lastname: Thornley-Brown
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cooper
authors.forename: Marino A
authors.initials: MA
authors.lastname: Bruce
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Keith C
authors.initials: KC
authors.lastname: Norris
authors.forename: James P
authors.initials: JP
authors.lastname: Lash
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D011307:Drug Prescriptions; D004651:Employment; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007182:Income; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000208:ethnology* / Q000503:physiopathology / Q000523:psychology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents