Still sad after successful renal transplantation: are we failing to recognise depression? An audit of depression screening in renal graft recipients.
BACKGROUND
Depression is common in chronic physical illness, including renal graft recipients. There is evidence that depression is an independent marker of poorer prognosis in dialysis patients. In the UK, screening is advocated by the National Institute for Health and Clinical Excellence guidelines, and validated screening tools exist, such as the Beck Depression Inventory (BDI).


METHODS
We audited our renal graft recipient outpatient clinic to see if screening was being undertaken by our clinicians, and to confirm the rates of depressive symptoms in our population as reported by the BDI.


RESULTS
In a sample of 58 transplant patients, we found that the screening rate for depression was poor, particularly by nephrologists (n = 8, 13.8%). In addition, 13 (22.4%) of our patients had significant depressive symptoms (BDI score ≥ 16). Following univariate analysis, we found that the most important predictor of current significant depressive symptoms was a past history of depression.


CONCLUSIONS
Despite the limitations of our small audit, our results confirm that depression is under-screened in renal graft recipients, even in those with a known history of depression. We recommend increased awareness of depression and implementation of regular screening in an outpatient setting; in this regard, the BDI may have utility.
Spencer
Benjamin Walter Jack
BW
South London and Maudsley NHS Trust, London, UK. benjamin.spencer @ slam.nhs.uk
Chilcot
Joseph
J
Farrington
Ken
K
D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012098:Reproduction; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014180:Transplantation / Q000523:psychology / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology