| Changes of Depressive Symptoms and Nutritional Indices after Antidepressant Treatment in the Patients with Chronic Hemodialysis and Depression |
| Yeon Soon Jung, M.D.1, Si-Sung Park, M.D.2, Eun-Jeong Min, M.A.2 Byung-Ho Han, M.D.1, Eun-A Eum, M.D.1 and Hark Rim, M.D.1 |
Department of Internal Medicine1
Neuropsychiatry2 , Kosin University Medical College, Busan, Korea |
| 원저 : 유지 혈액투석치료를 받는 만성신부전에 수반된 우울증에서 항우울제 치료에 따른 우울증상 및 영양지표의 변화 |
| 정연순1•박시성2•민은정2•한병호1•엄은아1•임 학1 |
| 고신대학교 의과대학 신장내과1, 신경정신과2 |
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| Abstract |
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Purpose : Depression is common in patients with chronic renal failure on maintenance hemodialysis, though success rate of treatment is low. This study aimed to investigate the features and severity of the depressive symptoms and nutritional indices, and significant changes after antidepressant treatment.
Methods : The authors assessed 45 patients. Diagnosis of depression was made using DSM-IV-TR and the depressive symptoms were evaluated using Hamilton Rating Scale for Depression via semistructured interview. Subjective global assessment, anthropometric measurements and nutritional indices such as Kt/V, nPCR were examined. Depressive patients were treated for 8 weeks with SSRI (citalopram), and all the variables were examined again after the treatment.
Results : 19 (42.2%) patients were diagnosed as depression. Nutritional status was not different between patients with depression and those without depression. Compared to non-depressed patients, depressed patients showed significantly higher depressed mood, guilty feeling, suicide idea, psychic and somatic anxiety, lower work and activities, psychomotor retardation, sleep disturbances, general somatic symptoms and hypochondriasis. After antidepressant treatment, depressed mood, guilty feeling, suicide idea, psychic anxiety, initial insomnia, middle insomnia, early awakening, work and activities and general somatic symptoms were improved significantly. TSF (p<0.05), handgrip strength (p<0.01) and hematocrit (p<0.05) were significantly increased.
Conclusion : Antidepressant treatment is helpful not only for the improvement of depressive symptoms such as sleep and somatic symptoms but for the improvement of quality of life. Proper treatment should be more actively attempted for the hemodialytic patients with depression. |
| Key Words:
Hemodialysis, Chronic renal failure, Nutritional status, Depression |
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