Depression and suicide risk in hemodialysis patients with chronic renal failure.
BACKGROUND
Depression and suicide are well established as prevalent mental health problems for patients on hemodialysis.


OBJECTIVE
The authors examined the demographic and psychological factors associated with depression among hemodialysis patients and elucidated the relationships between depression, anxiety, fatigue, poor health-related quality of life, and increased suicide risk.


METHODS
This cross-sectional study enrolled 200 end-stage renal disease patients age ≥18 years on hemodialysis. Psychological characteristics were assessed with the Mini-International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale, the short-form Health-Related Quality of Life Scale, and Chalder Fatigue Scale, and structural equation modeling was used to analyze the models and the strength of relationships between variables and suicidal ideation.


RESULTS
Of the 200 patients, 70 (35.0%) had depression symptoms, and 43 (21.5%) had had suicidal ideation in the previous month. Depression was significantly correlated with a low body mass index (BMI) and the number of comorbid physical illnesses. Depressed patients had greater levels of fatigue and anxiety, more common suicidal ideation, and poorer quality of life than nondepressed patients. Results revealed a significant direct effect for depression and anxiety on suicidal ideation.


CONCLUSIONS
Among hemodialysis patients, depression was associated with a low BMI and an increased number of comorbid physical illnesses. Depression and anxiety were robust indicators of suicidal ideation. A prospective study would prove helpful in determining whether early detection and early intervention of comorbid depression and anxiety among hemodialysis patients would reduce suicide risk.
Dept. of Psychiatry, Chang Gung Memorial Hospital at Keelung. No. 200 Ave 208 Chi-Chin-Yi Rd., Keelung, Taiwan.
Chih-Ken
CK
Chen
Yi-Chieh
YC
Tsai
Heng-Jung
HJ
Hsu
I-Wen
IW
Wu
Chiao-Yin
CY
Sun
Chia-Chi
CC
Chou
Chin-Chan
CC
Lee
Chi-Ren
CR
Tsai
Mai-Szu
MS
Wu
Liang-Jen
LJ
Wang
D000704:Analysis of Variance; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D059020:Suicidal Ideation