Distinct Depression Symptom Trajectories over the First Year of Dialysis: Associations with Illness Perceptions
Distinct Depression Symptom Trajectories over the First Year of Dialysis: Associations with Illness Perceptions
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DOI：
10.1007/s12160-012-9410-5
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发表时间：
2013-02-01
影响因子：
3.8
通讯作者：
Farrington, Ken
中科院分区：
文献类型：
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作者：
Chilcot, Joseph;Norton, Sam;Farrington, Ken
透析人群中抑郁症很常见，但抑郁症状的轨迹是未知的。本研究的目的是（1）检查是否存在不同模式的抑郁症状在第一年的透析和（2）了解疾病的看法是否与抑郁症状的观察轨迹。事件透析患者（n = 160）在开始透析后不久以及6个月和12个月时再次完成Beck抑郁量表II和修订的疾病感知问卷。潜在类别增长模型确定了不同的抑郁症状轨迹组，确定了三种抑郁轨迹：“低减少”（62%），“中度增加”（21.8%）和“高减少”（16.2%）。更高水平的抑郁与对疾病的理解（连贯性）和肾衰竭具有严重后果的看法以及更具周期性的时间轴相关。随着时间的推移，抑郁症状加重的患者认为治疗可以控制肾衰竭的信念逐渐减少。抑郁症状的不同模式与疾病感知有关。识别抑郁症状的常见模式的潜力可能有助于将治疗目标对准那些最有可能受益的人。
Depression in the dialysis population is common, but trajectories of depression symptoms are unknown.This study aims to (1) examine whether different patterns of depression symptoms exist over the first year of dialysis and (2) to understand if illness perceptions are associated with observed trajectories of depression symptoms.Incident dialysis patients (n = 160) completed the Beck Depression Inventory II and the Revised Illness Perception Questionnaire soon after starting dialysis and again at 6 and 12 months. Latent class growth modelling identified distinct groups of depression symptom trajectories.Three depression trajectories were identified: "low-reducing" (62 %), "moderate-increasing" (21.8 %) and "high-reducing" (16.2 %). Higher levels of depression were associated with a poorer understanding of the illness (coherence) and perceptions that kidney failure has severe consequences and a more cyclical timeline. Beliefs that treatment controlled kidney failure decreased over time in patients with increasing depression symptoms.Distinct patterns of depression symptoms are associated with illness perceptions. The potential to identify common patterns of depression symptoms may help target treatments at those most likely to benefit.