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Prospective study of depression among dialysis patients in Saudi Arabia

  • Nephrology - Original Paper
  • Published:
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Abstract

Objectives

The purpose was to determine the short-term course of depression among dialysis patients in Saudi Arabia and identify baseline characteristics that may influence course.

Methods

Thirty-nine dialysis patients in Jeddah, SA, were identified with subthreshold, minor, or major depressive disorders using the Structured Clinical Interview for Depression (SCID) and followed up at 6 and 12 weeks using the Longitudinal Interview and Follow-up Evaluation (LIFE) schedule. Depressive symptoms were tracked using the Hamilton Depression Rating Scale (HDRS). Patient characteristics measured at baseline included demographic, psychosocial, physical health, and treatment factors.

Results

Of the 20 patients with major or minor depressive disorder, eight (40 %) fully remitted by 6 weeks and an additional three patients remitted over the next 6 weeks, leaving 45 % with significant depressive symptoms persisting beyond 12 weeks. Subthreshold disorders followed a similar course (42 % with persistent symptoms). Few patients received treatment for depression. Those with more education, severe health problems, poorer psychological function, more severe depressive symptoms, or a family psychiatric history were less likely to remit. Similar factors predicted change in depressive symptoms assessed by HDRS, especially high medical co-morbidity, severe illness, and overall poor psychological functioning.

Conclusions

Nearly one-half of depressed dialysis patients in Saudi Arabia continue to have significant symptoms beyond 12 weeks of follow-up, few of whom were treated. Specific characteristics at baseline identify depressed dialysis patients at greater risk of persistent symptoms who need treatment.

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Notes

  1. Although higher baseline Global Assessment of Functioning (GAF) scores predicted worse outcomes (based on the “between-subjects” F value in the repeated-measures ANOVA), the time by GAF interaction (“within subjects”) effect was also significant (p = .036) meaning that this relationship was a complex one. Repeating the analyses using the mixed procedure in SAS, however, did not replicate this within-subjects finding.

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Acknowledgments

This project was funded by the Deanship of Scientific Research (DSR), King Abdulaziz University, Jeddah, under Grant No. 354/140/1433, including both DSR technical and financial support.

Conflict of interest

None of the authors have a conflict of interest.

Author information

Authors and Affiliations

  1. Psychiatry Division, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Faten Al Zaben, Mohammad Gamal Sehlo, Doaa Ahmed Khalifa & Harold G. Koenig

  2. Department of Psychiatry, Zagazig University, Zagazig, Egypt

    Mohammad Gamal Sehlo

  3. Department of Psychiatry, Ain Shams University, Cairo, Egypt

    Doaa Ahmed Khalifa

  4. Nephrology Division, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Saad Al Shohaib

  5. Renal Dialysis Unit, King Abdulaziz University, Jeddah, Saudi Arabia

    Saad Al Shohaib

  6. Renal Dialysis Unit, King Fahad Hospital, Jeddah, Saudi Arabia

    Faisul Shaheen

  7. Department of Mathematics, King Abdulaziz University, Jeddah, Saudi Arabia

    Linda Alzaben

  8. Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Rami Ghazi Ahmad, Jafar Ayman Ashy & Reema Ghazi Felemban

  9. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3400, Durham, NC, 27710, USA

    Harold G. Koenig

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  1. Faten Al Zaben
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  2. Mohammad Gamal Sehlo
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  10. Harold G. Koenig
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Correspondence to Harold G. Koenig.

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Al Zaben, F., Sehlo, M.G., Khalifa, D.A. et al. Prospective study of depression among dialysis patients in Saudi Arabia. Int Urol Nephrol 47, 1001–1010 (2015). https://doi.org/10.1007/s11255-015-0977-1

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  • DOI: https://doi.org/10.1007/s11255-015-0977-1

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