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Kidney Week

Abstract: TH-PO320

Depressive Symptoms as a Function of Race, Gender, and Perceived Social Support in End-Stage Kidney Disease

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wild, Marcus G., Vanderbilt University, Nashville, Tennessee, United States
  • Nair, Devika, Vanderbilt University, Nashville, Tennessee, United States
  • Umeukeje, Ebele, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Wallston, Ken, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Group or Team Name

  • Behavioral Medicine in Chronic Conditions Research Group
Background

Depression negatively impacts physical health and quality of life, and the prevalence of depressive symptoms in individuals receiving maintenance hemodialysis (HD) is 2-3 times higher than in the general population. Further, women and members of minority groups are at an increased risk for depression. Perceived social support (PSS) is found to have protective effects against depression. Yet, the effects of social support, gender, and race on depressive symptoms in HD patients is not well described.

Methods

117 patients (55% female, 72% self-reported African American (AA)) receiving in-center HD completed questionnaires assessing depressive symptoms and PSS. A 2x2x2 ANOVA was conducted to assess the main effects of PSS, gender, and race on depressive symptoms. Two-way interactions of race x PSS, gender x PSS, and race x gender, as well as the three-way interaction of race, gender, and PSS were also evaluated. Age and self-rated overall health were included as covariates.

Results

Analyses revealed significant main effects of age (p<.01), overall health (p<.01), and PSS (p<.01) on depressive symptoms. There was a significant interaction between PSS and race (p<.05), such that AAs had lower levels of depressive symptoms at low levels of PSS and higher levels of depressive symptoms at higher levels of PSS, as compared to whites. Further, there was a significant 3-way interaction among PSS, race, and gender (See Figure 1).

Conclusion

Gender and race are important modifiers of the effects of PSS on depressive symptoms. Patient characteristics such as race and gender should be taken into account when creating tailored, social support-based interventions to treat depression in HD patients.

Figure 1. Effect on depressive symptoms of the interaction of PSS, gender, and race.

Funding

  • NIDDK Support