Depression, Alexithymia and Long-Term Mortality in Chronic Hemodialysis Patients
Depression, Alexithymia and Long-Term Mortality in Chronic Hemodialysis Patients
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DOI：
10.1159/000319311
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发表时间：
2010-01-01
影响因子：
22.8
通讯作者：
Furukawa, Toshiaki A.
中科院分区：
文献类型：
--
作者：
Kojima, Masayo;Hayano, Junichiro;Furukawa, Toshiaki A.
背景：抑郁症会增加血液透析患者的死亡风险。据报道，述情障碍是一种情感调节障碍，与普通人群的死亡风险有关。我们进行了一项前瞻性研究，以评估抑郁症和述情障碍对长期死亡率的独立影响。方法：共有230名血液透析门诊患者，平均年龄为56.3±9.6岁，完成了一批自我报告测量，包括贝克抑郁量表-II（BDI-II）、20项多伦多述情障碍量表（TAS-20）和36项简表健康调查（SF-36）。每 6 个月确认一次生存状态，持续长达 5 年。抑郁症和述情障碍的存在分别由 BDI-II 评分≥14 和 TAS-20 评分≥61 来定义。结果：随访期间，确诊死亡27例。抑郁症和述情障碍都与全因死亡风险增加相关。经年龄和性别调整的抑郁症风险比为 2.36（95% CI：1.08-5.15；p = 0.03），述情障碍的风险比为 4.29（95% CI：1.95-9.42；p < 0.001）。控制述情障碍后，抑郁症失去了统计学显着性，而即使在调整基线抑郁症、健康状况（SF-36 的总分）、婚姻状况和临床协变量（多变量调整风险比 = 3.62；95% CI：1.32-9.93；p = 0.01）后，述情障碍仍然显着。结论：述情障碍是血液透析患者全因死亡的一个强有力的独立危险因素。版权所有 (C) 2010 S. Karger AG，巴塞尔
Background: Depression increases the risk of mortality in hemodialysis patients. Alexithymia, a disorder of affect regulation, has also been reported to be associated with mortality risk in the general population. We conducted a prospective study to estimate the independent impact of depression and alexithymia on long-term mortality. Methods: A total of 230 hemodialysis outpatients, with a mean age of 56.3 +/- 9.6 years, completed a batch of self-report measures including the Beck Depression Inventory-II (BDI-II), the 20-item Toronto Alexithymia Scale (TAS-20) and the 36-item Short Form Health Survey (SF-36). Survival status was confirmed every 6 months for up to 5 years. The presence of depression and alexithymia was defined by a BDI-II score of >= 14 and a TAS-20 score of >= 61, respectively. Results: During the follow-up period, 27 deaths were confirmed. Both depression and alexithymia were associated with an increased risk for all-cause mortality; the age-and sex-adjusted hazard ratio for depression was 2.36 (95% CI: 1.08-5.15; p = 0.03) and that for alexithymia was 4.29 (95% CI: 1.95-9.42; p < 0.001). Depression lost its statistical significance after controlling for alexithymia, whereas alexithymia remained significant even after adjusting for the baseline depression, health status (the summary scores of the SF-36), marital status and clinical covariates (multivariate adjusted hazard ratio = 3.62; 95% CI: 1.32-9.93; p = 0.01). Conclusions: Alexithymia is a strong independent risk factor for all-cause mortality in hemodialysis patients. Copyright (C) 2010 S. Karger AG, Basel