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Comparison of two self-report scales to assess anxiety and depressive symptoms in hemodialysis patients

Published:August 26, 2022DOI:https://doi.org/10.1016/j.apnu.2022.08.004

      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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