MP736INFLUENCE OF MEDICAL AND PSYCHOLOGICAL FACTORS ON DEPRESSION IN HEMODIALYSIS PATIENTS
Bibliographic record
Abstract
INTRODUCTION AND AIMS: Patients receiving maintenance hemodialysis (HD) with end-stage renal disease are increasing steadily every year. These patients have not only renal problems but also have various underlying diseases, which are very high mortality rates compared to the general population. Physical and mental limitations arise due to regular visits to the hospital for HD treatment. Psychiatric disorders are common due to a variety of causes, and the prevalence of depression is reported to range from 20 to 70%. However, since psychiatric diseases including depression are overlooked by nephrologists, the control of symptoms is very insufficient. The purpose of this study is to investigate the prevalence of depression in HD patients and to investigate the significant clinical factors and psychological factors including quality of life associated with depression. METHODS: The study included 160 patients who were undergoing HD. Patients receiving HD with acute kidney injury were excluded. Depression was assessed by the Hospital Anxiety Depression Scale, and was diagnosed when the scores for depression subscale were 8 points or higher. We evaluated clinical factors, including albumin, Kt/V as a marker of dialysis adequacy, normalized protein catabolic rate and duration of HD. Psychological factors were assessed using Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) was used to evaluate quality of life. RESULTS: The prevalence of depression in HD patients was 60.6% and the mean depression score was 8.91 ± 4.49 points. The mean age was 58.17 ± 11.87 years and 91 (56.9%) were men. The mean WHOQOL-BREF scores for each domain were as follows: 17.58 ± 5.51 in the physical health, 15.45 ± 4.68 in the psychological, 7.87 ± 2.47 in the social relationships and 20.97 ± 6.09 in the environmental. Depression was significantly associated with anxiety (p<0.001), social support (p=0.044), insomnia (p<0.001) and quality of life: physical health (p<0.001), psychological (p<0.001), social relationships (p=0.05), respectively. Multiple regression analysis showed that anxiety (p=0.002) and insomnia (p=0.02) were independent factors of depression. CONCLUSIONS: This study confirmed that depression occurs in many HD patients. Anxiety and insomnia appeared to be independent risk factors that negatively affect depression. Therefore, through the collaboration with psychiatrist, an accurate diagnosis and active treatment of depression are needed. We should develop programs to improve psychological factors such as anxiety and insomnia rather than improvement of clinical factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".