title: Depression, screening and quality of life in chronic kidney disease.
abstract: BACKGROUND
  To determine the prevalence of positive screens for depression and to assess quality of life (QoL) and usefulness of the brief and easily administered Patient Health Questionnaire-2 (PHQ-2) for depression screening in the chronic kidney disease (CKD) population; and to explore the relationship between depressive symptoms and markers of inflammation.
  
  
  METHODS
  Seventy-one adult patients with estimated glomerular filtration rate <60 mL/min/1.73 m or proteinuria, but not on dialysis, were enrolled. QoL was assessed using the Short Form-36. The Center for Epidemiological Studies Depression Scale (CES-D) and PHQ-2 were used to screen for depression. Serum ferritin, albumin, C-reactive protein and hematocrit were also measured as markers of inflammation.
  
  
  RESULTS
  The PHQ-2 and CES-D were significantly correlated (P < 0.05). Positive scores on the CES-D or PHQ-2 had significantly lower Short Form-36 scores. Mean hemoglobin values were significantly lower in patients who screened positive for depression either by CES-D (12.2 ± 1.7 versus 13.2 ± 1.7, P < 0.05) or by PHQ-2 (12 ± 1.6 versus 13.4 ± 1.6, P < 0.01). Neither PHQ-2 nor CES-D correlated with other markers of inflammation in this sample.
  
  
  CONCLUSIONS
  Both the CES-D and the PHQ-2 can identify patients with CKD who need further evaluation for depression. The PHQ-2 seems to be a useful screen for depression and impaired QoL in a renal clinic setting. Patients with CKD and lower hemoglobin may be at greater risk for depression than those with normal values.
authors.affiliation: VA Medical Center, University of Tennessee Health Science Center, Memphis, Tennessee, USA. Geeta.Gyamlani@va.gov
authors.forename: Geeta
authors.initials: G
authors.lastname: Gyamlani
authors.forename: Anita
authors.initials: A
authors.lastname: Basu
authors.forename: Stephen
authors.initials: S
authors.lastname: Geraci
authors.forename: Frederick
authors.initials: F
authors.lastname: Lee
authors.forename: Monique
authors.initials: M
authors.lastname: Moxey
authors.forename: Molly
authors.initials: M
authors.lastname: Clark
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dubbert
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000523:psychology; D011795:Surveys and Questionnaires