Cognitive Behavioral Treatment of Depression in ESRD PAtients on Dialysis

此应用程序的目的是供 Daniel Cukor 博士使用。过渡为独立调查员 社会心理肾病学领域。血液透析患者的抑郁症与血压降低有关 生活质量下降、饮食限制依从性差以及死亡率总体上升。这个提议 将帮助 Cukor 博士（一位训练有素的临床健康心理学家）测试认知行为疗法 (CBT) 专为不同种族的 ESRD 人群设计的干预措施，以减少他们的 抑郁影响水平并提高他们对血液透析健康生活方式的依从性。这是第一个 尝试通过受控的心理社会干预来治疗 ESRD 患者的抑郁症。下 在 Jeremy Coplan 医学博士、Paul Kimmel 医学博士和 Rolf Peterson 博士的指导下，教学经验 旨在帮助 Cukor 博士进一步提高他在肾脏病学、心理学理论和 干预以及研究方法。实际干预是基于传统的CBT治疗 根据 Cukor 博士之前的临床经验，对 ESRD 人群进行了修改，用于治疗抑郁症。 总体而言，本研究提供了一个模型来测试这种干预措施对血液透析患者的疗效与 等候名单控制。八十名受试者将被随机分配到干预第一条件或等待名单中 然后他们将接受 10 次干预。心理、生物和医学信息将 在干预前后以及后续行动中收集数据，以提供有关受试者情绪的数据， 生活质量、行为依从性、精神病理学以及疾病的一般影响。 该项目将为整个社区的健康做出贡献，因为它可以证明其功效 旨在针对种族多元化透析中的抑郁症和依从性的干预措施 人口。这可能支持以下观点：抑郁症和 ESRD 之间的关系是 双向，这意味着有效的社会心理干预不仅会影响抑郁情绪， 依从性、生活质量和疾病认知，还有实验室透析值，甚至可能 整体健康。如果它被证明是有益的，这种有针对性的、简短的干预措施可以纳入 所有抑郁症透析患者的护理标准。

The purpose of this application is for Daniel Cukor, Ph.D. to transition to an independent investigator in the field of psychosocial nephrology. Depression in hemodialysis patients has been associated with lower quality of life, poor compliance to dietary restrictions, and an overall increase in mortality. This proposal would help Dr. Cukor, a trained Clinical Health Psychologist, test a Cognitive Behavioral Therapy (CBT) Intervention that has been specifically designed for an ethnically diverse ESRD population to reduce their levels of depressive affect and improve their compliance with a hemodialysis-healthy lifestyle. This is the first attempt at treating depression in ESRD patients with a controlled psychosocial intervention. Under the mentorship of Jeremy Coplan, MD, Paul Kimmel, MD, and Rolf Peterson, Ph.D., a didactic experience has been devloped to help Dr. Cukor further his skills in the disciplines of nephrology, psychological theory and intervention, as well as research methodology. The actual intervention is based on traditional CBT treatment for depression with modifications for an ESRD population based on Dr. Cukor's previous clinical experience. Overall, this study provides a model to test the efficacy of this intervention on hemodialysis patients versus wait-list controls. Eighty subjects will be randomized to either the intervention first condition or the wait list and then they will receive the 10 session intervention. Psychological, Biological, and Medical information will be gathered before and after the intervention as well as at follow-up to provide data on the subjects' mood, quality of life, behavioral compliance, psychopathology and the general effects of their illness. This project stands to contribute to the health of the community at large, as it could demonstrate the efficacy of an intervention that is designed to target depression and compliance in an ethnically diverse dialysis population. This could lend support to the belief that the relationship between depression and ESRD is bidirectional, meaning that an effective psychosocial intervention will not only impact depressive affect, compliance, quality of life, and illness perceptions, but also laboratory dialysis values and even possibly overall health. If if it is proven to be benficial, this targeted and brief intervention could be incorporated into standard of care for all depressed dialysis patients.