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NDT Advance Access published online on March 6, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn105
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Screening for depression while patients dialyse: an evaluation

Joseph Chilcot1,2, David Wellsted2 and Ken Farrington1

1 Renal Unit, Lister Hospital Stevenage 2 Research Development Support Unit, University of Hertfordshire, UK

Correspondence and offprint requests to: J. Chilcot, Renal Unit Lister Hospital, Coreys Mill Lane, Stevenage, Hertfordshire, SG1 4AB, UK. Tel: +44-7988662216; E-mail: josephchilcot{at}nhs.net



  Abstract

Background. The lack of routine depression screening among the haemodialysis (HD) population may contribute to depression being under-recognised. While screening patients could be beneficial, the optimum screening procedure remains unclear. One method would be to screen HD patients while they receive their treatment. The purpose of this investigation was to determine whether the Beck Depression Inventory-II (BDI) could be administered while patients dialysed.

Methods. Forty HD patients completed the BDI while dialysing and again at a time when off-dialysis. Level of agreement analysis (Bland and Altman) was undertaken to determine if the assessment condition influenced BDI scoring. The off-dialysis assessment also involved a short clinical interview that was compared with the BDI assessment.

Results. There was a high level of agreement between the on- and off-dialysis assessments, but differences in response to the somatic items on the BDI scale were apparent between the conditions. The clinical interview revealed that 22% of the sample met the DSM-IV criteria for major depressive disorder. The optimal cut-off value for the BDI as determined by receiver operating characteristic curves was ≥16, with 88.9% sensitivity and 87.1% specificity.

Conclusion. The results indicate that the procedure of on-dialysis assessment using the BDI is a viable screening procedure. The practicality of employing this screening procedure may facilitate improved detection of depression in the dialysis population.

Keywords: agreement; beck depression inventory (BDI-II); depression; diagnosis; dialyse

Received for publication: 24. 9.07
Accepted in revised form: 5. 2.08


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