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Abstract: FR-PO446

Underdiagnosis of Depression in Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Soomar, Raeesa, Stony Brook University, Stony Brook, New York, United States
  • Jose, Reena, Stony Brook University, Stony Brook, New York, United States
  • Gupta, Anuj, Stony Brook University, Stony Brook, New York, United States
  • Davis, Morgan, Stony Brook University, Stony Brook, New York, United States
  • Hajagos, Janos G., Stony Brook University, Stony Brook, New York, United States
  • Koraishy, Farrukh M., Stony Brook University, Stony Brook, New York, United States
Background

Depression is the most common psychiatric illness among dialysis patients. It has been associated with adverse outcomes in this population, and therefore routine screening is recommended. The Patient Health Questionnaire (PHQ)-9 scale has been validated for depression screening in patients on hemodialysis (HD) in controlled studies, but it is underutilized in dialysis centers. The utility of PHQ-9 in detecting depression in HD patients without an official diagnosis and its association with psychiatric care is not well studied.

Methods

In a single center observational study of HD patients, we used PHQ-9 scores ≥ 10 as an indicator for depression. This was compared to diagnostic code-based depression diagnoses. Two-tailed t-tests were used to compare continuous variables, while Fischer’s exact and Chi square tests were used to compare categorical variables.

Results

Among the 98 HD patients analyzed, the mean age was 61.5 years, mean days on HD were 2,005; 91% had hypertension, 59% diabetes and 87% had cardiovascular disease. Eighteen (18.4%) patients were diagnosed with depression using the PHQ-9. Of these, only six (33%) also had a diagnostic code-based depression diagnosis, nine (50%) had a follow-up appointment scheduled with a psychiatrist, and only five (28%) were being treated with an anti-depressant. Patients with depression were also more likely to have comorbid anxiety disorder and a greater number of previous hospitalizations (p<0.05).

Conclusion

Depression is underdiagnosed in HD patients. Better screening for depression will lead to improved medical care and potentially better health outcomes for this vulnerable population.