Highlights
- •Anxiety and depression assessment in dialysis patients using HADS and BSI scales
- •HADS and BSI instruments of anxiety and depression are moderately-strongly correlated.
- •The prevalence of anxiety is higher at different cut-offs of BSI versus HADS, with better agreement at depression scale.
- •A high cut-off for BSI (≥1.58) is recommended for better anxiety screening when using HADS as a reference.
Abstract
Introduction
Psychiatric illness is prevalent among hemodialysis (HD) patients. This study compared
the assessment of anxiety and depressive symptoms among HD patients using two self-administered
scales; hospital anxiety and depression scale (HADS) and brief symptom inventory (BSI).
Methods
A cross-sectional study was conducted among a convenience sample of HD patients (n = 352)
from different dialysis centers in Jordan. Patients were interviewed in dialysis units,
and demographics, clinical status, disease, and dialysis history data were collected.
Symptoms of anxiety (HADS-A ≥ 8 and BSI-A ≥ 0.82) and depression (HADS-D ≥ 8 and BSI-D ≥ 0.82)
were also measured.
Results
The mean age of participants was 52.2 ± 15.6 years. The majority had been receiving
HD three times daily and for >2 years. A significant moderate-strong correlation was
observed between HADS-A and BSI-A (r = 0.753, p < 0.0001) as well as HADS-D and BSI-D
(r = 0.588, p < 0.0001). Anxiety prevalence was 43.7 % using HADS-A ≥ 8 and 80.7 %
using BSI-A ≥ 0.82, while depression prevalence was 53.1 % using HADS-D ≥ 8 and 51.7 %
using BSI-D ≥ 0.82. When HADS was used as a standard, the operating characteristics
reveal that a higher cut-off for BSI-A is recommended (≥1.58) for better anxiety screening.
Discussion
Specific and suitable cut-off points need to be further explored and validated for
HADS and BSI scales among patients undergoing dialysis.
Keywords
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References
- Prevalence of depression, anxiety, and their associations among end-stage renal disease patients on maintenance hemodialysis: A multi-center population-based study.Psychology, Health & Medicine. 2021; 26: 1134-1142https://doi.org/10.1080/13548506.2020.1852476
- Investigating the contribution of NPSR1, IL-6 and BDNF polymorphisms to depressive and anxiety symptoms in hemodialysis patients.Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2019; 94109657https://doi.org/10.1016/j.pnpbp.2019.109657
- Association of brain-derived neurotrophic factor and interleukin-6 serum levels with depressive and anxiety symptoms in hemodialysis patients.General Hospital Psychiatry. 2018; 53: 25-31https://doi.org/10.1016/j.genhosppsych.2018.04.003
- Spirituality, anxiety and depression among people receiving hemodialysis treatment in Jordan: A cross-sectional study.Journal of Religion and Health. 2020; https://doi.org/10.1007/s10943-020-00988-8
- Social determinants of health associated with hemodialysis non-adherence and emergency department utilization: A pilot observational study.BMC Nephrology. 2020; 21: 4https://doi.org/10.1186/s12882-019-1673-7
- Correlates of symptoms of depression and anxiety in chronic hemodialysis patients.General Hospital Psychiatry. 2010; 32: 125-131https://doi.org/10.1016/j.genhosppsych.2009.10.009
- Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors.General Hospital Psychiatry. 2018; 54: 31-36https://doi.org/10.1016/j.genhosppsych.2018.08.007
- Depression symptoms in haemodialysis patients predict all-cause mortality but not kidney transplantation: A cause-specific outcome analysis.Annals of Behavioral Medicine. 2018; 52: 1-8https://doi.org/10.1007/s12160-017-9918-9
- Depressive symptoms in dialysis: Prevalence and relationship with uremia-related biochemical parameters.Blood Purification. 2018; 46: 286-291https://doi.org/10.1159/000491014
- The Brief Symptom Inventory: An introductory report.Psychological Medicine. 1983; 13 (http://www.ncbi.nlm.nih.gov/pubmed/6622612): 595-605
- An integrative review of depression in patients receiving hemodialysis for end-stage renal disease and the relevance to patients with wounds.Wound Management & Prevention. 2019; 65: 28-34
- Anxiety-depression of dialysis patients and their caregivers.Medicina (Kaunas, Lithuania). 2019; 55https://doi.org/10.3390/medicina55050168
- Comparison of two self-rating scales to detect depression: HADS and PHQ-9.The British Journal of General Practice. 2009; 59: e283-e288https://doi.org/10.3399/bjgp09X454070
- Feasibility of using Arabic Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression among patients attending Accident and Emergency at a University Hospital setting in Riyadh,Saudi Arabia.Pakistan Journal of Medical Sciences. 2015; 31: 1366-1371https://doi.org/10.12669/pjms.316.6849
- Depression and medication adherence in patients on hemodialysis.Current Hypertension Reviews. 2017; 13: 138-143https://doi.org/10.2174/1573402113666171129182611
- Perceived social support is a partial mediator of the relationship between depressive symptoms and quality of life in patients receiving hemodialysis [Research Support, Non-U.S. Gov’t].Archives of Psychiatric Nursing. 2014; 28: 114-118https://doi.org/10.1016/j.apnu.2013.11.007
- Depressive symptoms and dietary adherence in patients with end-stage renal disease [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't].Journal of Renal Care. 2011; 37: 30-39https://doi.org/10.1111/j.1755-6686.2011.00202.x
- The psychometric properties of the Brief Symptom Inventory depression and anxiety subscales in patients with heart failure and with or without renal dysfunction [Research support, N.I.H., Extramural].Archives of Psychiatric Nursing. 2011; 25: 419-429https://doi.org/10.1016/j.apnu.2010.12.005
- Prevalence, detection and associations of depression in Australian dialysis patients.Australasian Psychiatry. 2019; 27: 444-449https://doi.org/10.1177/1039856219859281
- The correlations among depressive symptoms, cognitive performance and serum BDNF levels in the patients with chronic kidney disease.Psychiatry Investigation. 2018; 15: 186-192https://doi.org/10.30773/pi.2017.03.09
- Emotional symptoms, quality of life and cytokine profile in hemodialysis patients [Research Support, Non-U.S. Gov't].Clinical Nephrology. 2010; 73 (http://www.ncbi.nlm.nih.gov/pubmed/20040350): 36-43
- Quality of life, depression, adherence to treatment and illness perception of patients on haemodialysis.International Journal of Nursing Practice. 2015; 21: 1-10
- Prevalence of depression in chronic kidney disease: Systematic review and meta-analysis of observational studies.Kidney International. 2013; 84: 179-191https://doi.org/10.1038/ki.2013.77
- Screening for anxiety and depression in dialysis patients: comparison of the Hospital Anxiety and Depression Scale and the Beck Depression Inventory [Comparative Study Research Support, Non-U.S. Gov't].Journal of Psychosomatic Research. 2012; 73: 139-144https://doi.org/10.1016/j.jpsychores.2012.04.015
- Dimensions of depressive symptoms and their association with mortality, hospitalization, and quality of life in dialysis patients: A cohort study.Psychosomatic Medicine. 2019; 81: 649-658https://doi.org/10.1097/psy.0000000000000723
- Anxiety symptoms, mortality, and hospitalization in patients receiving maintenance dialysis: A cohort study.American Journal of Kidney Diseases. 2019; 74: 158-166https://doi.org/10.1053/j.ajkd.2019.02.017
- Reference values for generic instruments used in routine outcome monitoring: The Leiden Routine Outcome Monitoring Study.BMC Psychiatry. 2012; 12: 203https://doi.org/10.1186/1471-244x-12-203
- Depression in chronic kidney disease and end-stage renal disease: Similarities and differences in diagnosis, epidemiology, and management.Kidney International Reports. 2017; 2: 94-107https://doi.org/10.1016/j.ekir.2016.09.005
- The impact of anxiety and depression on the quality of life of hemodialysis patients.Global Journal of Health Science. 2015; 8: 45-55https://doi.org/10.5539/gjhs.v8n1p45
- Indicators and correlates of psychological disturbance in Chinese patients receiving maintenance hemodialysis: A cross-sectional study.International Urology and Nephrology. 2015; 47: 679-689https://doi.org/10.1007/s11255-015-0910-7
- Development and preliminary validation of a self-rating anxiety inventory for maintenance haemodialysis patients.Psychology, Health & Medicine. 2021; 1–13https://doi.org/10.1080/13548506.2021.1890159
- The hospital anxiety and depression scale.Acta Psychiatrica Scandinavica. 1983; 67 (http://www.ncbi.nlm.nih.gov/pubmed/6880820): 361-370
Article info
Publication history
Published online: August 26, 2022
Accepted:
August 21,
2022
Received in revised form:
August 12,
2022
Received:
March 1,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
