[Prevalence and correlates of anxiety and depression in patients with end-stage renal disease (ESRD)].

OBJECTIVES: Depressive symptoms are common among patients with end-stage renal disease (ESRD). They are associated with both high morbidity and high mortality. In this explorative study we investigated the frequency of Major Depression and Generalized Anxiety Disorder in a German dialysis center. We further investigated the correlation between expert-rating and self-report questionnaires as well as the extent to which somatic, dialysis-specific and sociodemographic parameters are associated with depressive and anxious symptoms.
METHOD: During dialysis treatment 52 patients (21 women and 31 men) aged 29 to 85 years with end-stage renal disease (ESRD) completed the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS-D). A physician administered the Structured Clinical Interview for DSM-IV (SCID) for the expert diagnosis of Major Depression and Generalized Anxiety Disorder.
RESULTS: Nine patients met DSM-IV criteria for Major Depression (17 %). The self-report scales showed depressive symptoms in 17 patients (33 %) and 8 patients (15 %), respectively. Generalized Anxiety Disorder according to SCID was diagnosed in 9 patients (17 %), while 12 patients (23 %) scored higher than seven points on the HADS Anxiety subscale. Depressive and anxious symptoms were associated with gender, employment status, and physical activity; anxious symptoms were also associated with the body-mass-index (BMI).
CONCLUSIONS: The higher agreement between the HADS depression subscale and the SCID diagnosis of Major Depression suggests that the HADS-D depression subscale is more useful than the BDI when screening for depression in patients with ESRD. Physical activity seems to be a protective factor for patients with ESRD and should be further investigated.