In the UT Southwestern Medical Center study, available online and in the Sept. 15 issue of Kidney International, researchers monitored 98 dialysis patients for up to 14 months. More than a quarter of dialysis patients received a psychiatric diagnosis of some form of depression based on a Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM IV).
This is the first reported link between adverse clinical outcomes in dialysis patients and depression made through a formal psychiatric interview based on the DSM-IV standards.
More than 80 percent of the depressed patients died or were hospitalized, compared with 43 percent of non-depressed patients. Cardiovascular events, which previously have been linked to depression, led to 20 percent of the hospitalizations.
Dr. Susan Hedayati, assistant professor of internal medicine, has demonstrated that depressed patients undergoing dialysis are nearly twice as likely to be hospitalized or die within a year than those who are not depressed. Twenty percent of patients who start dialysis will die by the end of the first year," said Dr. Susan Hedayati, assistant professor of internal medicine and the study's lead author.
"What we don't know yet is, if their depression is treated, could it extend dialysis patients' survival and improve their quality of life," she added.
Dr. Hedayati, a staff nephrologist at the Dallas Veterans Affairs Medical Center, said depression-like symptoms - such as loss of energy, poor appetite and sleep disturbances - are often observed in patients with chronic disease, so it is important to get a scientifically valid diagnosis for clinical depression.