• Can J Kidney Health Dis · Jan 2019

    Single Questions for the Screening of Anxiety and Depression in Hemodialysis.

    • David Collister, Jennifer C Rodrigues, Andrea Mazzetti, Kelsi Salisbury, Laura Morosin, Christian Rabbat, K Scott Brimble, and Michael Walsh.
    • Department of Medicine, McMaster University, Hamilton, ON, Canada.
    • Can J Kidney Health Dis. 2019 Jan 1; 6: 2054358118825441.

    BackgroundDepression and anxiety are common and underrecognized in end-stage renal disease (ESRD), are associated with poor outcomes and reduced health-related quality of life, and are potentially treatable. Simple, accurate screening tools are needed.ObjectiveWe examined the operating characteristics of single questions for anxiety and depression from the Edmonton Symptom Assessment System (ESAS) in hemodialysis.DesignCross-sectional study.SettingTwo outpatient hemodialysis units (1 tertiary, 1 community) in Hamilton, Canada.PatientsAdult prevalent hemodialysis patients.MeasurementsESAS and Hospital Anxiety and Depression Scale (HADS).MethodsParticipants were asked the degree to which they experienced anxiety and depression using the ESAS. ESAS single questions for anxiety and depression were compared with the reference standard of the HADS using dialysis population specific cutoffs (HADS anxiety subscale ≥6 and HADS depression subscale ≥7). Logistic regression was used to create receiver operating characteristics (ROC) curves.ResultsWe recruited 50 participants with a mean age of 64 (SD = 12.4) years, of whom 52% were male and 96% were on ≥3× weekly hemodialysis. Using the reference standards, 28 (56%) had a diagnosis of anxiety and 27 (54%) had a diagnosis of depression. Areas under the ROC curves were 0.83 for anxiety and 0.81 for depression using ESAS scores of ≥2.LimitationsSample size and the lack of a reference gold standard.ConclusionsThe ESAS single questions for anxiety and depression have reasonable discrimination in a hemodialysis population. The use of more complex and time-consuming screening instruments could be reduced by adopting the ESAS questions for anxiety and depression in hemodialysis.

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