How Dialysis Patients Live: A Study on Their Depression and Associated Factors in Southern Italy

Abstract

Depression is an independent risk factor of poor outcomes for Chronic Kidney Disease (CKD) patients. Perceived social support and alexithymia are psychosocial variables identified by previous studies as predictive of depression in normal controls and CKD patients. Repetitively thinking and socially sharing emotional experiences have been investigated in association with depression in normal populations. Our cross-sectional study aimed to assess the effects of perceived social support, alexithymia, mental rumination, and social sharing on depression in CKD patients and controls. 103 CKD patients (age = 61.9 ± 7.2, 54 men) and 101 controls (age = 64.51 ± 6.56; 47 men) completed a questionnaire of 5 sections: Pluridimensional Inventory for Haemodialysis Patients (IPPE), Multidimensional Scale of Perceived Social Support (MSPSS), Geriatric Depression Scale (GDS), Toronto Alexihymia Scale (TAS-20), Social Sharing and Mental Rumination. Multiple regression analysis models with dummy variables assessed the effects of IPPE, MSPSS, TAS-20, Social Sharing, and Mental Rumination on GDS across the subgroups of participants. SPSS software was used. Depression levels resulted higher for patients than controls, especially in patients dialyzed for less than 4 years. The effects of perceived social support and alexithymia differed with respect to the subsamples. Rumination was positively associated with depression in normal controls, but negatively related with depression in patients dialyzed for 4+ years. The study confirmed high levels of depression in CKD patients. Depression was influenced by perceived social support, alexithymia, and the cognitive elaboration of emotional troubles associated with the disease. Rumination appeared as a dysfunctional consequence of emotions for normal controls, but had an adaptive function for patients dialyzed for 4+ years.

Depression in Patients with CKD: A Person Centered Approach

“…The prognosis of depression, as we said, is considerably higher in patients with CKD than in general population [28]. The remarkable finding of a survey is that patients undergoing dialysis for more than four years indicate lower scores on scales of depression than patients in the first four years of dialysis [28].…”

Influence of Selected Biomarkers on Stress and Alexithymia in Patients Under Hemodialysis Treatment

“…The biomarkers of urea, creatinine, hemoglobin, hematocrit, albumin, sodium, potassium, calcium, phosphorus, and C-reactive protein (CRP) values of the subjects who participate in the study were evaluated. The median number of medications used by the patients on a daily basis was three (min-max: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Normally deviating values were determined and the relationship between the HSS, HSS subscales, TAS-20, and TAS-20 subscale scores was assessed.…”

“…Pop-Jordanova and Polenakovic reported that half of the patients who received hemodialysis treatment in Macedonia (n = 230) appeared alexithymic. 12 In a study they conducted, Sinatra et al (2011) found that the primary psychiatric outlook that accompanied depression was alexithymia in patients under hemodialysis treatment for 4 years and above. 19 As a result of our research, we found that the increase in the length of hemodialysis treatment is in direct proportion to the emergence of alexithymic symptoms.…”

“…12 In a study they conducted, Sinatra et al (2011) found that the primary psychiatric outlook that accompanied depression was alexithymia in patients under hemodialysis treatment for 4 years and above. 19 As a result of our research, we found that the increase in the length of hemodialysis treatment is in direct proportion to the emergence of alexithymic symptoms. It was reported that 31.5% of the subjects received hemodialysis treatment for nine months or less, 32.5% received treatment between 9 and 24 months, and 36% were under hemodialysis treatment for more than 24 months in research conducted by Davison and Jhangri (2005), while the mean hemodialysis treatment period of hemodialysis patients was reported as 58.75 ± 48.94 months in a different study.…”

Mental Health Effects Of Biomarkers In Chronic Renal Failure: Stress And Alexithymia Dimention

“…HSS has been identified in HD patients as physical (HSS-1) and psychosocial stressors (HSS-2) and the markers of physical stressors were indicated with six (2,3,7,10,11,20) questions. Questionnaires for psychosocial stressors were determined with 23 (1,4,5,6,8,9,12,13,14,15,16,17,18,19,21,22,23,24,25,26,27,28,29) items [14]. The physical hemodialysis stressor score is 6-30 and the psychosocial hemodialysis stressor score is 23-115 points.…”