Depression and its 6-month course in untreated hemodialysis patients: a preliminary prospective follow-up study in Turkey

The major goal of this study is to assess the frequency of psychiatric disorders in end-stage renal disease (ESRD) patients, who were on hemodialysis (HD) treatment in Turkey. Additionally, it aims to determine whether depression, anxiety, and functional and occupational levels of patients who did not receive any psychiatric treatments change at the end of 6 months. We conducted Structured Clinical Interview for the DSM-IV, Clinical Version on 50 HD patients, and 16 (32%) fulfilled the criteria for a psychiatric disorder. Depressive disorder, not otherwise specified, was observed in 12 (24%) patients. Adjustment disorder with depressed mood and dysthymic disorder were observed in 8% of our population. Fourteen patients were followed up for 6 months. All patients were assessed with Hamilton Depression (HDRS), Anxiety Rating Scale (HARS), and Global Assessment of Functioning (GAF) at baseline and at 6 months. The comparisons of baseline and 6 months HDRS, HARS, and GAF scale scores did not reveal any statistically significant differences in 14 depressed patients. The level of depression, anxiety, and functional and occupational impairment did not remit spontaneously in our untreated depressed HD patients. We believe that further studies regarding categorization, prognosis, and treatment of these patients are needed to better understand what to do when we encounter depressive ESRD patients.