Screening for depression in hemodialysis

: Prevalence of depression symptoms, which is high among geriatric individuals, it is even higher in hemodialysis patients. In this study we performed a screening for depression symptoms in 82 elderly hemodialysis patients, by means of 3 different ultra-brief questionnaires, proposed for geriatric population by the American Geriatric Society Guide-Lines. At the beginning, patients were requested to fill out the ultra-brief Patient Health Questionnaire (PHQ), which consists of only 2 questions. A score of 3 or greater prompted the administration of the brief version of the Geriatric Depression Scale (GDS-5) and of the full PHQ-9. A GDS-5 score of 2 or greater was considered as positive for depression screening. PHQ-9 scores of 5, 10, 15 and 20 represented the cutpoints for mild, moderate, moderately severe and severe depression, respectively. PHQ-2 score was 3 or greater in 43.9% of patients (n= 36), in which GDS-5 resulted as positive in all of the patients. Further, PHQ-9 scores stratified depression symptoms as follows: mild 22.2%, moderate 16.6%, moderately severe 39% and severe 22.2%. Our sample showed high prevalence of depression symptoms, which were relevant (moderate or worse) in almost 80% of patients. PHQ-2 appeared to be extremely useful, since 100% of patients with PHQ-2 score of 3 or greater had positive GDS-5 score. In conclusion, screening of depression symptoms by ultra-brief self-administered questionnaires may be very simple and useful in hemodialysis patients, therefore it should be encouraged.