Identifying Depression in Individuals with Renal Disease

According to the National Institute for Mental Health, nearly 10% of Americans have mood problems, and those with End Stage Renal Disease (ESRD) are twice as likely to have symptoms of depression. In individuals who have received a kidney transplant, and those awaiting one, depression directly affects mortality because it influences a client’s outlook, disposition and adherence to treatment. Therefore, determining who is at increased risk for depression among this group of people is critically important. In an attempt to identify which scale is most effective for measuring depression in clients with ESRD, researchers at Simon Fraser University and the University of British Columbia assessed 455 clients, with and without ESRD, using the Beck Depression Inventory –II (BDI-II) and the Center for Epidemiologic Studies Depression Scale (CES-D).

Although the BDI-II is reliable for identifying depressive symptoms in the general population, the team theorized that the CES-D would be a more accurate tool for people with ESRD. “The CES–D differs from this and other self-report measures of depression, in that it specifically examines symptoms separately within four distinct domains (Depressive Affect, Absence of Well-Being, Somatic Symptoms, and Interpersonal Affect),” said  Theone S. E. Paterson  of Simon Fraser University and lead author of the study. “This differentiation between four symptom domains offered by the CES–D incorporates the ability to explore the presence or absence of positive affect and interpersonal symptoms, which may allow for a more comprehensive, although still brief and easily manageable, assessment of depression in this patient population.”

The researchers found that the measures provided in the CES-D isolated specific symptoms of depression more accurately than the BDI-II, particularly in the second-order depression symptoms. “Specifically, this information may be important in the characterization of depression among these patients.” The team added, “Use of the CES-D will not only save clinicians (and patients) time in assessment but will also ensure that important aspects of depression are assessed, likely increasing accuracy of diagnosis and subsequent treatment.”

Paterson, T. S. E., O’Rourke, N., Elmer, E., Shapiro, R. J., & Thornton, W. L. (2011, September 12). The Composition and Structure of Depressive Symptomatology in Renal Disease. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement. Advance online publication. doi: 10.1037/a0025104

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Michel J.

    Michel J.

    September 21st, 2011 at 11:29 AM

    Wow, i never thought depression could be a matter of life and death for a person. But yes, our outlook has a lot to do with everything about us :|

    And if one method is giving a better way to identify and measure this depression then i say we should give it all the push we can and hope to see it being adopted everywhere, so that we can better identify those at risk and provide help to them.

  • Neely


    September 21st, 2011 at 12:25 PM

    To have live your life hooked to a dialysis machine as many end stage renal patients have to face is pretty scary, and yes I can see how this very easily could feed the depression of one who is already predisposed to living with this condition. A disease like renal disease has to feel very terminal and there fore it is easy that one could slip into feeling sorry for himself and feeling like there is no end in sight. And given that many have waited for years for a transplant that never comes through for them has to make them feel even worse about their situation.

  • Simon V.

    Simon V.

    September 23rd, 2011 at 3:33 PM

    Nothing is more depressing than knowing that their are kidneys out there but you’re still number 33 in line or whatever this may be. All you have left to do is wait for a new kidney as you slowly die, hoping that you’ll get your kidney before it is too late. When hope is all you have left and you are powerless to changing how soon you get a transplant, not being depressed would be more unusual.

    Therapy should be a standard for those with renal disease ,not just something that you should consider doing. Your will to survive is very strong indeed, and therapy could hold your will strong even through the worst of depression.

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