1. ¹Division of Nephrology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
2. ²Division of Nephrology, Department of Medicine, Veterans Affairs Medical Center, Dallas, Texas, USA
3. ³Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
4. ⁴Veterans Affairs Medical Center, Center for Health Services Research in Primary Care, Durham, North Carolina, USA
5. ⁵Quintiles, Medical and Scientific Services, Research Triangle Park, North Carolina, USA
6. ⁶Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA
7. ⁷Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, Washington DC, USA
8. ⁸Division of Nephrology, Department of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA

Correspondence: S. Susan Hedayati, VA North Texas Health Care System, Nephrology Section, MC 111G1, 4500 South Lancaster Road, Dallas, Texas 75216-7167, USA. E-mail: susan.hedayati@utsouthwestern.edu

⁹This study was completed while L.P. Briley was a nephrology fellow at Duke University Medical Center and before she joined Quintiles.

Received 15 January 2008; Revised 24 March 2008; Accepted 29 April 2008; Published online 25 June 2008.

Abstract

Depressive symptoms, assessed using a self-report type of questionnaire, have been associated with poor outcomes in dialysis patients. Here we determined if depressive disorders diagnosed by physicians are also associated with such outcomes. Ninety-eight consecutive patients on chronic hemodialysis underwent the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders administered by a physician. Depression was diagnosed in about a quarter of the patients. Associations adjusted for age, gender, race, time on dialysis and co-morbidity were determined using survival analysis. Using time to event (death or hospitalization) models of analysis the hazard ratios were 2.11 and 2.07 in unadjusted and adjusted models respectively. The finding of poor outcome using a formal structured physician interview suggests that a prospective study is needed to determine whether treatment of depression affects clinical outcomes.