The Diagnosis of Major Depression in End-Stage Renal Disease

Abstract

Background: Although major depression commonly occurs in medically ill patients, it can be difficult to diagnose since depression and many medical illnesses share common physical symptoms. Methods: This study was designed to evaluate patients with end-stage renal disease (ESRD) for major depressive disorder using three diagnostic approaches, to assess the Beck Depression Inventory as a screening instrument for major depression, and to examine the association of anhedonia with a diagnosis of major depression in ESRD patients who deny depressed mood. Results: Rates of major depression varied from 6 to 34% according to the criteria that were used. The sensitivity of the Beck Depression Inventory was found to be modest. Anhedonia was a helpful clue for diagnosing depression in patients who denied depressed mood. Conclusions: The findings illustrate the current difficulties in applying DSM criteria for major depression to medical patients and underscore the need for more specific guidelines.

Is depression a risk factor for mortality in chronic hemodialysis patients?

“…The BDI scores observed in our population (mean = 16.2 ± 10.6 and median = 14) fell within the range defined as mild depression by Beck et al, 12 and were similar to the scores reported by other investigators. [21][22][23] The choice of a cutoff of 14 for the BDI score was mainly related to obtaining two groups with similar samples sizes, no intention to establish a particular level to be used for BDI. Instead, this choice was focused on creating two distinct groups, one with less intense depressive symptoms and the other with more intense symptoms.…”

Depression, Alexithymia and Long-Term Mortality in Chronic Hemodialysis Patients

“…The second edition of the Beck Depression Inventory-II (BDI-II) [28] was used to assess the level of depressive symptoms. The BDI is the most popular self-reporting tool for measuring depressive symptoms and has often been used to evaluate mental health in ESRD patients [29]. It was revised to correspond to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and was published as the BDI-II in 1996.…”

Screening, Diagnosis, and Treatment of Depression in Patients with End-Stage Renal Disease

“…To address the need for brief assessment tools for health professionals who perceive that they have limited time to conduct evaluations, O'Donnell and Chung (42) evaluated the use of very brief screening questions in the assessment of depression. These studies have shown that one-or two-question assessments, focusing on the core symptom of depressed mood or anhedonia, can prove useful in the medically ill (42).…”