Based on the recent clinical experiences, the pattern of depression in the hemodialysis patients
seems to have changed as compared to the past This study is designed to find out the characteristics
of depression in the hemodialysis patients nowadays and factors influencing the depression.
Fifty End Stage Renal Disease(ESRD) patients receiving hemodialysis were interviewed according
to a schedule to collect data. Their depression was assessed with Hamilton’s Depression
Scale and Zungs Self Rating Scale. The data were compared with 45 patients who were diagnosed
as neurotic depression in psychiatric outpatients clinic.
The results are as follows :
1) The depression in hemodialysis patients was not more severe than that of neurotic depression.
This suggests that the severity of depression in the hemodialysis patients have decreased
apparently as compared to the past. This may be due to general socioeconomic improvement
in Korean society, improved financial support by medical insurance system, improvement of
therapeutic techniques and environments of hemodialysis rooms and changed view on hemodialysis
of the people. Fear of death and fear of life, and fear of dependence to the machines
that were used to be attributed to the depression in the past were still influential, but less
than the past.
2) Comparing with neurotic patients, the hemodialysis patients presented less of depressive
symptoms such as depressed mood, agitation, anxiety(psychological, physical) and somatic
symptoms. Thus, the psychological symptoms such as low of interest and suicidal ideation
are more valuable to evaluate the depression of the hemodialysis patients than vegetative symptoms.
3) Economic problem appeared to be the most significant cause of depression in the hemodialysis
patients. Other causes were family problem and sexual problem. The duration of hemodialysis
is longer, the depression is more sever and the severity of depression tended to increase
as the patients get old.
4) In the hemodialysis patients, religion and higher education appeared to be related with
less severity of depression. Thus, to help the patients, it is recommended the hemodialysis
patients to have religious faith and the educational programs