Prevalence of major depressive episode in CKD.
Prevalence of major depressive episode in CKD.
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DOI：
10.1053/j.ajkd.2009.03.017
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发表时间：
2009-09
期刊：
影响因子：
--
通讯作者：
Rush AJ
中科院分区：
文献类型：
--
作者：
Hedayati SS;Minhajuddin AT;Toto RD;Morris DW;Rush AJ
抑郁症在长期透析患者中很普遍，并与死亡和住院有关。目前尚不清楚抑郁症是存在于慢性肾脏病(CKD)的所有阶段，还是出现在透析治疗开始之后。我们使用结构化的黄金标准临床访谈和与CKD患者的主要抑郁发作相关的人口统计学和临床变量来确定严重抑郁发作和其他精神疾病的患病率。使用《精神疾病诊断和统计手册》(第四版)的观察性横断面研究，由训练有素的人员对272名连续参与者进行结构化访谈。多变量Logistic回归用于确定与主要抑郁发作相关的人口统计学和临床变量。来自退伍军人事务部CKD诊所的2-5期CKD患者未使用透析治疗。人口统计学和临床变量。通过基于《精神障碍结构化诊断和统计手册》(第四版)的访谈--迷你国际神经精神病学访谈--诊断出的主要抑郁发作。队列的平均年龄为64.5±12.0岁。38%的人是非裔美国人，55%的人患有糖尿病。2、3、4和5期CKD患者的比例分别为6%、38%、41%和14%。平均血红蛋白水平为12.5±2.0g/dL。主要抑郁发作的发生率为21%，在不同的CKD阶段之间没有显著差异。与主要抑郁发作相关的变量包括糖尿病、合并精神疾病以及药物或酒精滥用史。主要由男性退伍军人组成的单中心研究。每5名CKD患者中就有一人有严重的抑郁发作。在接受维持性透析的终末期肾病患者中，考虑到抑郁症的高患病率以及抑郁与不良预后的独立关联，CKD患者应该常规筛查抑郁症。
Depression is prevalent in long-term dialysis patients and is associated with death and hospitalization. Whether depression is present through all chronic kidney disease (CKD) stages or appears after dialysis therapy initiation is not clear. We determined the prevalence of a major depressive episode and other psychiatric illnesses by using a structured gold-standard clinical interview and demographic and clinical variables associated with major depressive episode in patients with CKD. Observational cross-sectional study using a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based structured interview administered by trained persons to 272 consecutive participants. Multivariable logistic regression was used to determine demographic and clinical variables associated with major depressive episode. Patients with stages 2 to 5 CKD not treated by using dialysis were consecutively approached and enrolled from a Veterans Affairs CKD clinic. Demographic and clinical variables. Major depressive episode diagnosed by using a structured Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based interview, the Mini International Neuropsychiatric Interview. The cohort had a mean age of 64.5 ± 12.0 years. Thirty-eight percent were African American, and 55% had diabetes mellitus. Percentages of patients with stages 2, 3, 4, and 5 CKD were 6%, 38%, 41%, and 14%, respectively. Mean hemoglobin level was 12.5 ± 2.0 g/dL. The prevalence of a major depressive episode was 21% and did not vary significantly among different CKD stages. Variables associated with a major depressive episode were diabetes mellitus, comorbid psychiatric illness, and history of drug or alcohol abuse. Single-center study composed of primarily male veterans. One in 5 patients with CKD had a major depressive episode. Patients with CKD should be screened routinely for depression given this high prevalence and the independent association of depression with poor outcomes in patients with end-stage renal disease receiving maintenance dialysis.
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DOI：
10.2215/cjn.00030505
发表时间：
2006-05-01
影响因子：
9.8
作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
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