title: Psychosocial risk and protective factors for depression in the dialysis population: a systematic review and meta-regression analysis.
abstract: OBJECTIVE
  Research into the association between psychosocial factors and depression in End-Stage Renal Disease (ESRD) has expanded considerably in recent years identifying a range of factors that may act as important risk and protective factors of depression for this population. The present study provides the first systematic review and meta-analysis of this body of research.
  
  
  METHODS
  Published studies reporting associations between any psychosocial factor and depression were identified and retrieved from Medline, Embase, and PsycINFO, by applying optimised search strategies. Mean effect sizes were calculated for the associations across five psychosocial constructs (social support, personality attributes, cognitive appraisal, coping process, stress/stressor). Multiple hierarchical meta-regression analysis was applied to examine the moderating effects of methodological and substantive factors on the strength of the observed associations.
  
  
  RESULTS
  57 studies covering 58 independent samples with 5956 participants were identified, resulting in 246 effect sizes of the association between a range of psychosocial factors and depression. The overall mean effect size (Pearsons correlation coefficient) of the association between psychosocial factor and depression was 0.36. The effect sizes between the five psychosocial constructs and depression ranged from medium (0.27) to large levels (0.46) with personality attributes (0.46) and cognitive appraisal (0.46) having the largest effect sizes. In the meta-regression analyses, identified demographic (gender, age, location of study) and treatment (type of dialysis) characteristics moderated the strength of the associations with depression.
  
  
  CONCLUSIONS
  The current analysis documents a moderate to large association between the presence of psychosocial risk factors and depression in ESRD.
authors: Consultation Liaison Psychiatry, Liverpool Hospital, Sydney, Australia. ramony.chan@sswahs.nsw.gov.au
authors: Ramony
authors: R
authors: Chan
authors: Zachary
authors: Z
authors: Steel
authors: Robert
authors: R
authors: Brooks
authors: Tracy
authors: T
authors: Heung
authors: Jonathan
authors: J
authors: Erlich
authors: Josephine
authors: J
authors: Chow
authors: Michael
authors: M
authors: Suranyi
mesh_terms: D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D006435:Renal Dialysis / Q000523:psychology*; D012307:Risk Factors; D012944:Social Support