The Authors Reply

Abstract

We appreciate the interest in our recently published article ‘Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis (HD) patients’, which presented the advantages of a specific psychological approach to treat depression in Brazilian patients undergoing hemodialysis.1.Kusztal M. Trafidlo A. Weyde W. et al.Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis (HD) patients.Kidney Int. 2010; 77: 646-647Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar,2.Duarte P.S. Miyazaki M.C. Blay S.L. et al.Cognitive-behavioral group therapy is an effective treatment for major depression in hemodialysis patients.Kidney Int. 2009; 76: 414-421Abstract Full Text Full Text PDF PubMed Scopus (151) Google Scholar The authors recognize the importance of studying in more depth the relationship of physical symptoms, such as pain, in chronic kidney disease and its treatment, with both the functional status and the psychosocial well-being of these patients. The prevalence of chronic pain in patients of our study was high. At the beginning of the study, the percentage of patients with body pain was similar in the two study groups: 84.8% (n=39) in the cognitive-behavioral therapy group and 84.1% (n=37) in the control group. After 3 months, this prevalence rate decreased in the intervention group (78.0% (n=32)) and increased in the control group (88.6% (n=39)). Muscle pain was present in 71.7% (n=33) and 72.7% (n=32) of the patients in the intervention and the control groups, respectively, at baseline. The corresponding figures after 3 months of study were 73.2 and 72.7%, respectively. Seventy-two percent (n=33) of the patients in the intervention group and 72.7% (n=32) of the patients in the control group stated at baseline that the pain interfered with their normal work. After 3 months, these percentages changed to 58.5 and 81.8% in the cognitive-behavioral therapy (CBT) and control groups, respectively. The relationship between pain and depression in end-stage renal disease patients is important. The impact of CBT in alleviating body pain in these patients requires future research.