Screening for depression while patients dialyse: an evaluation

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2008-08, Vol.23 (8), p.2653-2659
• Main Authors: Chilcot, Joseph, Wellsted, David, Farrington, Ken
• Format: Article
• Language: English
• Subjects: Adult; Aged; agreement; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; beck depression inventory (BDI-II); Biological and medical sciences; depression; Depression - diagnosis; Depression - etiology; Depressive Disorder, Major - diagnosis; diagnosis; dialyse; Emergency and intensive care: renal failure. Dialysis management; Female; Glomerulonephritis; Hemodiafiltration - adverse effects; Hemodiafiltration - psychology; Humans; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Male; Mass Screening - methods; Mass Screening - statistics & numerical data; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Psychiatric Status Rating Scales; Renal Dialysis - adverse effects; Renal Dialysis - psychology; United Kingdom
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfn105

Background. The lack of routine depression screening among the haemodialysis (HD) population may contribute to depression being under-recognised. While screening patients could be beneficial, the optimum screening procedure remains unclear. One method would be to screen HD patients while they receive their treatment. The purpose of this investigation was to determine whether the Beck Depression Inventory-II (BDI) could be administered while patients dialysed. Methods. Forty HD patients completed the BDI while dialysing and again at a time when off-dialysis. Level of agreement analysis (Bland and Altman) was undertaken to determine if the assessment condition influenced BDI scoring. The off-dialysis assessment also involved a short clinical interview that was compared with the BDI assessment. Results. There was a high level of agreement between the on- and off-dialysis assessments, but differences in response to the somatic items on the BDI scale were apparent between the conditions. The clinical interview revealed that 22% of the sample met the DSM-IV criteria for major depressive disorder. The optimal cut-off value for the BDI as determined by receiver operating characteristic curves was ≥16, with 88.9% sensitivity and 87.1% specificity. Conclusion. The results indicate that the procedure of on-dialysis assessment using the BDI is a viable screening procedure. The practicality of employing this screening procedure may facilitate improved detection of depression in the dialysis population.