Depression in chronic dialysis patients: assessment and treatment

Finkelstein, Fredric O.; Finkelstein, Susan H.

doi:10.1093/ndt/15.12.1911

Cited by 218 publications

(182 citation statements)

References 11 publications

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“…The impact that mental health treatment has on outcomes is still unclear. Some evidence 2,3,28,120,123,124,149 suggests that depression can be successfully treated in ESRD populations, but the potentially greater impact of improved psychological functioning on burden of care, intimate relationships, compliance, QOL, and mortality is largely unexplored. The results of interventions in earlier stages of renal disease are also unknown, as well as the role of interventions in children.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,34,120,121 Pharmacologic options to treat depression include selective serotonin reuptake inhibitors (SSRIs), as well as the newer selective serotonin and norepinephrine reuptake inhibitors. 24,34,115,[122][123][124][125] Other agents such as tricyclic antidepressants, monoamine oxidase inhibitors, and St. John's wort should be avoided if possible because of potential exacerbation of common adverse events in dialysis patients, including drug-drug interactions, arrhythmias, and orthostatic hypotension. 24,115,122,125 Patients who receive these antidepressant medications should be closely monitored for development of a prolonged corrected QT interval.…”

Section: Anxietymentioning

confidence: 99%

See 1 more Smart Citation

Psychosocial Aspects of Chronic Disease

Cukor¹,

Cohen²,

Peterson³

et al. 2007

Journal of the American Society of Nephrology

333

274

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Section: Discussionmentioning

confidence: 99%

Section: Anxietymentioning

confidence: 99%

Psychosocial Aspects of Chronic Disease

Cukor¹,

Cohen²,

Peterson³

et al. 2007

Journal of the American Society of Nephrology

333

274

View full text Add to dashboard Cite

“…[1][2][3][4][5][6][7][8][9][10] Depression in ESRD patients has received much scientific attention and has been associated with lower quality of life (QOL), [11][12][13] decreased adherence to the dialysis presciption, [14][15][16] greater medical comorbidity, and decreased survival. [17][18][19][20][21] It is unclear whether depression has a direct causal role in poor outcomes associated with ESRD or if depression is rather a marker of increased disease comorbidity and illness severity.…”

mentioning

confidence: 99%

Psychosocial Intervention Improves Depression, Quality of Life, and Fluid Adherence in Hemodialysis

Cukor¹,

Halen²,

Asher³

et al. 2014

Journal of the American Society of Nephrology

208

234

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Patients with ESRD have high rates of depression, which is associated with diminished quality of life and survival. We determined whether individual cognitive behavioral therapy (CBT) reduces depression in hemodialysis patients with elevated depressive affect in a randomized crossover trial. Of 65 participants enrolled from two dialysis centers in New York, 59 completed the study and were assigned to the treatment-first group (n=33) or the wait-list control group (n=26). In the intervention phase, CBT was administered chairside during dialysis treatments for 3 months; participants were assessed 3 and 6 months after randomization. Compared with the wait-list group, the treatment-first group achieved significantly larger reductions in Beck Depression Inventory II (self-reported, P=0.03) and Hamilton Depression Rating Scale (clinician-reported, P,0.001) scores after intervention. Mean scores for the treatment-first group did not change significantly at the 3-month follow-up. Among participants with depression diagnosed at baseline, 89% in the treatment-first group were not depressed at the end of treatment compared with 38% in the wait-list group (Fisher's exact test, P=0.01). Furthermore, the treatment-first group experienced greater improvements in quality of life, assessed with the Kidney Disease Quality of Life Short Form (P=0.04), and interdialytic weight gain (P=0.002) than the wait-list group, although no effect on compliance was evident at follow-up. In summary, CBT led to significant improvements in depression, quality of life, and prescription compliance in this trial, and studies should be undertaken to assess the long-term effects of CBT on morbidity and mortality in patients with ESRD.

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“…17 The BDI has been used extensively in end-stage renal disease (ESRD) populations. [18][19][20] The standard cutoff for increased depressive affect is a score of 10 or greater in the general population 17 ; however, in ESRD populations, a score of 15 or greater is suggested. 18,[21][22][23] …”

Section: Beck Depression Inventory-ii (Bdi)mentioning

confidence: 99%

Barriers to immunosuppressive medication adherence in high‐risk adult renal transplant recipients

Constantiner

Cukor

2011

Dialysis & Transplantation

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BACKGROUNDNon‐adherence to immunosuppressive medication in renal transplant recipients is a primary cause of kidney rejection. However, little is known about the reasons transplant patients are non‐adherent. We report on the specific barriers to medication adherence in 94 kidney transplant recipients from a medical center in Brooklyn, New York.METHODSTransplant patients waiting for their monthly medical appointment completed questionnaires relating to their adherence, level of depression, barriers to medication taking, and beliefs in their abilities to take their medication as prescribed.RESULTSThe particular barriers that were most associated with lower levels of adherence were too many doses per day, too many pills per dose, having to remember to take medication, perceived side effects of medication, skipping a dose to feel good, falling out of a daily routine, and being short of money. The overall level of barriers that the sample endorsed was associated with increased depression (r = 0.209, p = 0.049) and decreased medi‐cation self‐efficacy (r = −0.300, p = 0.004). An elevation in the “unintentional” factor of the barriers scale was significantly associated with depression (r = 0.211, p = 0.046), but not directly with adherence. The “deliberate” factor was associated with non‐adherence (r = −0.21, p < 0.05) but not depression (r = 0.173, p > 0.05)CONCLUSIONSThere may be two reasons transplant recipients are non‐adherent to prescribed medications. One set of barriers is related to deliberately choosing to skip doses, and the other set is related to inadvertent or uncontrollable situations. Interventions designed to promote adherence in this population should address both pathways. Dial. Transplant. © 2011 Wiley Periodicals, Inc.

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Depression in chronic dialysis patients: assessment and treatment

Cited by 218 publications

References 11 publications

Psychosocial Aspects of Chronic Disease

Psychosocial Aspects of Chronic Disease

Psychosocial Intervention Improves Depression, Quality of Life, and Fluid Adherence in Hemodialysis

Barriers to immunosuppressive medication adherence in high‐risk adult renal transplant recipients

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