Robbert W Schouten1, Els Nadort2, Wouter van Ballegooijen3, Wim L Loosman4, Adriaan Honig5, Carl E H Siegert6, Yvette Meuleman7, Birit F P Broekman5. 1. Department of Nephrology, OLVG Hospital, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: r.schouten@olvg.nl. 2. Department of Psychiatry, OLVG Hospital, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. 3. Department of Clinical Psychology, Amsterdam UMC, VUmc, Amsterdam, the Netherlands; Department of Specialized Mental Health Care, GGZ InGeest, Amsterdam, the Netherlands. 4. Department of Nephrology, OLVG Hospital, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, VUmc, Amsterdam, the Netherlands. 5. Department of Psychiatry, OLVG Hospital, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, VUmc, Amsterdam, the Netherlands. 6. Department of Nephrology, OLVG Hospital, Amsterdam, the Netherlands. 7. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands.
Abstract
OBJECTIVE: Depression and anxiety often coexist in patients with end-stage-kidney disease. Recently, studies showed that a composite 'general distress score' which combines depression and anxiety symptoms provides a good fit in dialysis and oncology patients. We aim to investigate if the three most frequently used self-report questionnaires to measure depression and anxiety in dialysis patients are sufficiently unidimensional to warrant the use of such a general distress score in two cohorts of dialysis patients. METHODS: This study includes two prospective observational cohorts of dialysis patients (total n = 749) which measured depression and anxiety using Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Hospital Anxiety and Depression Scale (HADS). Confirmatory factor analyses was used to investigate both a strictly unidimensional model and a multidimensional bifactor model that includes a general distress, depression and anxiety factor. The comparative fit index (CFI) and The Root Mean Square Error of Approximation (RMSEA) were used as model fit indices. RESULTS: Factor analysis did not show a good fit for a strictly unidimensional general distress factor for both the BDI/BAI and HADS (CFI 0.690 and 0.699, RMSEA 0.079 and 0.125 respectively). The multidimensional model performed better with a moderate fit for the BDI/BAI and HADS (CFI 0.873 and 0.839, RMSEA 0.052 and 0.102). CONCLUSIONS: This data shows that the BDI/BAI and HADS are insufficiently unidimensional to warrant the use of a general distress score in dialysis patients without also investigating anxiety and depression separately. Future research is needed whether the use of a general distress score might be beneficial to identify patients in need of additional (psychological) support.
OBJECTIVE:Depression and anxiety often coexist in patients with end-stage-kidney disease. Recently, studies showed that a composite 'general distress score' which combines depression and anxiety symptoms provides a good fit in dialysis and oncology patients. We aim to investigate if the three most frequently used self-report questionnaires to measure depression and anxiety in dialysis patients are sufficiently unidimensional to warrant the use of such a general distress score in two cohorts of dialysis patients. METHODS: This study includes two prospective observational cohorts of dialysis patients (total n = 749) which measured depression and anxiety using Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Hospital Anxiety and Depression Scale (HADS). Confirmatory factor analyses was used to investigate both a strictly unidimensional model and a multidimensional bifactor model that includes a general distress, depression and anxiety factor. The comparative fit index (CFI) and The Root Mean Square Error of Approximation (RMSEA) were used as model fit indices. RESULTS: Factor analysis did not show a good fit for a strictly unidimensional general distress factor for both the BDI/BAI and HADS (CFI 0.690 and 0.699, RMSEA 0.079 and 0.125 respectively). The multidimensional model performed better with a moderate fit for the BDI/BAI and HADS (CFI 0.873 and 0.839, RMSEA 0.052 and 0.102). CONCLUSIONS: This data shows that the BDI/BAI and HADS are insufficiently unidimensional to warrant the use of a general distress score in dialysis patients without also investigating anxiety and depression separately. Future research is needed whether the use of a general distress score might be beneficial to identify patients in need of additional (psychological) support.
Authors: Helena Garcia-Llana; Nayara Panizo; Lorena Gandía; Marisa Orti; Elena Giménez-Civera; Claudia Forquet; Luis D'Marco; Maria Jesús Puchades; Mari Sargsyan; Irina Sanchís; Carmen Ribera; Mª Inés Marco; Cristela Moncho Ferrá; Carmen María Pérez-Baylach; Begoña Bonilla; Francesc Moncho Francés; Elisa Perez-Bernat; Asunción Sancho; Jose Luis Górriz Journal: Vaccines (Basel) Date: 2022-02-16