Frequency and Correlates of Depression in Hemodialysis Patients versus Apparently Healthy Population in Egypt

Abstract

Background: Depression is the most common mental health condition in the general population. Additionally, depression is common in hemodialysis patients and is associated with a lower quality of life. The social causes of depression have been ignored for a long time. We aimed to assess the severity and correlates of depression in HD patients and compare them to a group of apparently healthy individuals in Egypt. Methods and Subjects: The study was conducted in four dialysis units in Egypt where 234 patients and 242 healthy individuals were recruited. The depression scoring, demographic data, and associated comorbidities were recorded. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D), NIMH. The higher scores indicated the presence of more symptomatology. Results: The total studied groups were 234(136 males, 98 females) patients on dialysis with a mean age of 55.6±13.6 years (range 21–79 years), and 242(157 males, 85 females) healthy individuals with a mean age of 33.6±13.3 years (range 18–70 years). Females both in dialysis patients as well as in the controls had statistically significantly higher depression scores indicating more depressive symptoms, than their male counterparts. Depression scores were significantly negatively correlated with the ages of control individuals, while they had non-significant positive correlations with ages and BMIs in cases. More depressive symptoms were associated with better socioeconomic status and higher education in the control group, although depressive symptoms increased with lower socioeconomic status and lower level of education in HD patients. In HD patients, the severity of depressive symptoms was significantly related to the presence of diabetes mellitus and ischemic heart disease. On the other hand, the more depressive symptoms in HD patients without associated comorbidities were not statistically significantly different from that in the apparently healthy group. Conclusion: The severity of depressive symptoms was different demographically between hemodialysis patients and the apparently healthy individuals, and was more pronounced in patients with more advanced age, lower socioeconomic status, and lower education, necessitating more consideration of social and psychological care for these patients.