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KMID : 0359920080270010094
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Korean Journal of Nephrology
2008 Volume.27 No. 1 p.94 ~ p.101
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Changes of Depressive Symptoms and Nutritional Indices after Antidepressant Treatment in the Patients with Chronic Hemodialysis and Depression
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Jung Yeon-Soon
Park Si-Sung
Min Eun-Jeong
Han Byung-Ho
Eum Eun-A
Rim Hark
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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.
Conclusions: 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.
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KEYWORD
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Hemodialysis, Chronic renal failure, Nutritional status, Depression
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