title: Citalopram versus psychological training for depression and anxiety symptoms in hemodialysis patients.
abstract: BACKGROUND
  This study was designed to compare an antidepressant medication, citalopram, with psychological training in hemodialysis patients with symptoms of anxiety and depression.
  
  
  METHODS
  A total number of 44 hemodialysis patients scored 8 and more on the Hospital Anxiety and Depression Scale (HADS) were randomly allocated to two groups to receive citalopram, 20 mg/d, for 3 months or to attend 6 sessions of 1-hour psychological training. A nephrologist and a senior psychiatry resident were responsible for training of the patients, which contained explaining the anatomy of the kidneys, causes of kidney failure, treatment modalities, the mechanism involved in hemodialysis, the required care in hemodialysis patients, stages of adaptive reaction in human, and techniques of problem solving, stress management, and muscle relaxation. Both groups completed the HADS once before and once after the treatment. The final results of the two groups were compared.
  
  
  RESULTS
  Citalopram administration led to a significant decrease in the patients' depression score (P = .001), anxiety score (P = .048), and total HADS score (P = .002). Psychological training sessions also decreased significantly depression (P = .04), anxiety (P = .03), and total HADS scores (P = .045). There was no significant difference in the amount of decrease in the scores of depression (P = .65), anxiety (P = .19), and the total HADS (P = .66) between the two groups.
  
  
  CONCLUSIONS
  Psychological training and citalopram have similar effects on improving the symptoms of anxiety and depression in hemodialysis patients.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Seyed Hamzeh
authors.initials: SH
authors.lastname: Hosseini
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Espahbodi
authors.forename: Seyyed Mohammad Mehdi
authors.initials: SM
authors.lastname: Mirzadeh Goudarzi
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000628:therapy*; D015283:Citalopram / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D006435:Renal Dialysis / Q000523:psychology*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram