Psychosocial interventions for treating depression in dialysis patients

Depression is the most common psychological problem in the chronic dialysis population and it affects their physical, mental and social well-being. The aim of this review was to determine the effectiveness of psychosocial interventions (e.g. cognitive behavioural therapy) for treating depressed dialysis patients. No relevant randomised controlled trials were identified. Large, long-term studies are needed in this area.

Authors' conclusions: 

Data were not available to draw conclusions about the effectiveness of psychosocial interventions in the treatment of depression in the chronic dialysis population, as we did not find any RCTs of psychosocial interventions to treat depression in dialysis patients. This review highlights the need for commencing and completing adequately powered RCTs to address the issue of psychosocial interventions for depression in dialysis patients.

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Background: 

Depression is the most common psychological problem in the dialysis population. The diagnosis of depression in dialysis patients is confounded by the fact that several symptoms of uraemia mimic the somatic components of depression. It affects the physical, psychological and social well being of the dialysis population in several ways.

Objectives: 

The aim of this systematic review was to assess the effectiveness of psychosocial interventions in the treatment of depression in patients who are dialysed for end-stage renal disease.

Search strategy: 

A comprehensive search strategy was employed to identify all randomised controlled trials (RCTs) relevant to the treatment of depression in dialysis patients. The following databases were searched - MEDLINE (1966 - October 2003), EMBASE (1980 - October 2003), PsycINFO (1872 - October 2003) and The Cochrane Library (issue 3, 2003). Authors of potential studies were contacted, reference lists of identified RCTs and relevant narrative reviews were screened.

Selection criteria: 

RCTs comparing any psychosocial intervention with control intervention or no intervention in depressed dialysis patients.

Data collection and analysis: 

Data were to be abstracted by two investigators independently onto a standard form and entered into Review Manager. Risk ratio (RR) for dichotomous data and mean difference (MD) for continuous data were to be calculated with 95% confidence intervals (CI).

Main results: 

Despite extensive searching, no RCTs were identified.

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