Still Sad after Successful Renal Transplantation: Are We Failing to Recognise Depression? An Audit of Depression Screening in Renal Graft Recipients

Abstract

Background: Depression is common in chronic physical illness, including renal graft recipients. There is evidence that depression is an independent marker of poorer prognosis in dialysis patients. In the UK, screening is advocated by the National Institute for Health and Clinical Excellence guidelines, and validated screening tools exist, such as the Beck Depression Inventory (BDI). Methods: We audited our renal graft recipient outpatient clinic to see if screening was being undertaken by our clinicians, and to confirm the rates of depressive symptoms in our population as reported by the BDI. Results: In a sample of 58 transplant patients, we found that the screening rate for depression was poor, particularly by nephrologists (n = 8, 13.8%). In addition, 13 (22.4%) of our patients had significant depressive symptoms (BDI score ≧16). Following univariate analysis, we found that the most important predictor of current significant depressive symptoms was a past history of depression. Conclusions: Despite the limitations of our small audit, our results confirm that depression is under-screened in renal graft recipients, even in those with a known history of depression. We recommend increased awareness of depression and implementation of regular screening in an outpatient setting; in this regard, the BDI may have utility.

Prevalence and Modifiable Determinants of Non-Adherence in Adult Kidney Transplant Recipients in a German Sample

“…These feelings may be counteracted by health activities and adherence. Similar to findings of Spencer et al (2011) our findings highlight the need to screen for affective changes such as depression and anxiety, in kidney transplant recipients. Further analysis of anxiety and its relationship to adherence in the context of transplantation is needed.…”

Depression and Mortality in End-Stage Renal Disease

“…For the purposes of this paper, we examine the sequelae of depression in ESRD patients being treated with hemodialysis, the most prevalent treatment option. (For a discussion of mental health issues following renal transplantation, see other recent papers [11][12][13][14][15].) CKD patients have many characteristics that are similar to those of individuals from other chronically medically ill populations.…”

Anxiety and depression in patients with end-stage renal disease: impact and management challenges – a narrative review

“…Patients with a history of psychiatric illness were found to be more prone to develop depression after renal transplantation. 19,67,68 Comorbidity might also increase the risk of development of depression and anxiety. For instance, patients with depressive symptoms were also found to have other comorbid illnesses such as diabetes mellitus, hypertension, cardiovascular heart disease, hypoalbuminemia, and substance abuse.…”