DEPRESSION, PERCEPTION OF ILLNESS AND MORTALITY IN PATIENTS WITH END-STAGE RENAL-DISEASE

被引:140
作者
PETERSON, RA
KIMMEL, PL
SACKS, CR
MESQUITA, ML
SIMMENS, SJ
REISS, D
机构
[1] GEORGE WASHINGTON UNIV,MED CTR,DEPT MED,2150 PENN AVE NW,WASHINGTON,DC 20037
[2] GEORGE WASHINGTON UNIV,DEPT PSYCHOL,WASHINGTON,DC 20052
[3] GEORGE WASHINGTON UNIV,DEPT PSYCHIAT,WASHINGTON,DC 20052
关键词
DEPRESSION; CHRONIC KIDNEY FAILURE; HEMODIALYSIS; CONTINUOUS AMBULATORY PERITONEAL DIALYSIS; MEDICAL PSYCHOLOGY; SURVIVAL;
D O I
10.2190/D7VA-FWEU-JN5Y-TD3E
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
A role of depression in affecting outcome in patients with end stage renal disease (ESRD) has been suggested but few have assessed psychological parameters and medical factors thought to influence survival simultaneously and prospectively. To assess whether depression or perception of illness influences survival in patients treated for ESRD, we prospectively evaluated fifty-seven patients with ESRD treated with hemodialysis (HD, n = 43) or continuous ambulatory peritoneal dialysis (CAPD, n = 14). Patients were interviewed and completed the Beck Depression Inventory (BDI) and the Illness Effects Questionnaire (IEQ). An ESRD severity coefficient was used to measure chronic illness severity. A cognitive item subset of the BDI (CDI) was used as an additional measure of depression. One and two years later, records were examined to determine survival. When initial results of the assessment of survivors and non-survivors were compared, at one year follow-up, there were no differences in mean age, duration of dialysis, severity scores, BDI or IEQ scores. The initial mean CDI scores in the group of non-survivors, however, were significantly greater than the scores in the survivor group. At two year follow-up, CDI scores were significantly different between groups, and were significant in a hazards regression. Disease severity, age and duration of dialysis were also significantly related to mortality at two year follow-up. We conclude cognitive depression is an important, early, indicator of grave prognosis in patients treated for ESRD. Early recognition of and therapeutic efforts directed toward the treatment of depression might modify outcome in ESRD patients.
引用
收藏
页码:343 / 354
页数:12
相关论文
共 35 条
  • [1] SELF-REPORT SYMPTOMS THAT PREDICT MAJOR DEPRESSION IN PATIENTS WITH PROMINENT PHYSICAL SYMPTOMS
    ABBEY, SE
    TONER, BB
    GARFINKEL, PE
    KENNEDY, SH
    KAPLAN, AS
    [J]. INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE, 1990, 20 (03) : 247 - 258
  • [2] AN INVENTORY FOR MEASURING DEPRESSION
    BECK, AT
    ERBAUGH, J
    WARD, CH
    MOCK, J
    MENDELSOHN, M
    [J]. ARCHIVES OF GENERAL PSYCHIATRY, 1961, 4 (06) : 561 - &
  • [3] PSYCHOMETRIC PROPERTIES OF THE BECK DEPRESSION INVENTORY - 25 YEARS OF EVALUATION
    BECK, AT
    STEER, RA
    GARBIN, MG
    [J]. CLINICAL PSYCHOLOGY REVIEW, 1988, 8 (01) : 77 - 100
  • [4] THE RELATIONSHIP OF DEPRESSION TO SURVIVAL IN CHRONIC-RENAL-FAILURE
    BURTON, HJ
    KLINE, SA
    LINDSAY, RM
    HEIDENHEIM, AP
    [J]. PSYCHOSOMATIC MEDICINE, 1986, 48 (3-4): : 261 - 269
  • [5] COHENCOLE SA, 1987, PSYCHIAT CLIN N AM, V10, P1
  • [6] EMOTIONAL REACTIONS OF PATIENTS ON CHRONIC HEMODIALYSIS
    DENOUR, AK
    SHALTIEL, J
    CZACZKES, JW
    [J]. PSYCHOSOMATIC MEDICINE, 1968, 30 (5P1): : 521 - &
  • [7] DENOUR AK, 1982, AM J PSYCHIAT, V139, P97
  • [8] FOSTER FG, 1973, PSYCHOSOM MED, V35, P64
  • [9] GROUP PARTICIPATION AND SURVIVAL AMONG PATIENTS WITH END-STAGE RENAL-DISEASE
    FRIEND, R
    SINGLETARY, Y
    MENDELL, NR
    NURSE, H
    [J]. AMERICAN JOURNAL OF PUBLIC HEALTH, 1986, 76 (06) : 670 - 672
  • [10] HINRICHSEN GA, 1989, PSYCHOSOMATICS, V30, P234