Depression Is Often Undertreated in Patients on Hemodialysis

Negative perceptions of depression and its treatment, including concerns regarding antidepressant medication side effects, are often a barrier to receiving treatment for depression among patients on hemodialysis, according to a recent study.

Depression is common in patients with end-stage renal disease (ESRD) but is often underdiagnosed.
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To identify potential barriers in diagnosing depression in this patient population, the researchers evaluated 160 patients on chronic maintenance hemodialysis. Patients were administered the Perceived Barriers to Psychological Treatment questionnaire, which was adapted to include screening. Patients with depressive symptoms were identified using the 2-item Patient Health Questionnaire.

Approximately 73.1% of participants reported at least 1 barrier that prevented them from receiving treatment for depression. The likelihood of reporting at least 1 barrier to a screening program for depression was higher in those with depressive symptoms vs those without depressive symptoms. This association remained significant following adjustment for patient characteristics.

Concerns regarding antidepressant medication side effects (40%), having more medications (32%), feeling that the problem is not severe enough (23%), and perceiving no risk of depression (23%) were the most commonly reported barriers to receiving treatment.

“Negative perceptions about depression and its treatment among hemodialysis patients constitute an important barrier to identifying this condition and first need to be addressed before implementing a screening program in this population,” the researchers concluded.

—Christina Vogt

Reference:

Farrokhi F, Beanlands H, Logan A, Kurdyak P, Jassal SV. Patient-perceived barriers to a screening program for depression: a patient opinion survey of hemodialysis patients. Clin Kidney J. 2017;10(6):830-837. https://doi.org/10.1093/ckj/sfx047.