Prevalence of Depression in Jordanian Hemodialysis Patients

Background: Although depression is recognized as the most common psychiatric disorder in hemodialysis patients with a significant negative impact on management and prognosis, we didn't find any previous data regarding its prevalence in Jordanian patients. Objectives: We conducted this study to determine the prevalence of depression in Jordanian hemodialysis patients, the factors that may influence it, and to boost the awareness of its detrimental consequences. Methods: In a descriptive cross-sectional study, patients on hemodialysis at the University of Jordan hospital in July 2015 participated in this survey utilizing a validated Arabic translation of the patient health questionnaire 9 (PHQ 9). The patients answered the questionnaire on the same day of dialysis, specifically, a few hours post dialysis when the effects of indistinguishable uremic symptoms are minimal. Results: From the 49 patients that completed the survey, we found 29% to have depression, though significantly higher than the general population, however, considerably lower than similar studies. This finding may be due to the critical timing of questionnaire answering that had been ignored in other studies and led to an overestimation of the diagnosis of depression in hemodialysis patients. Interestingly, most patients were unaware of the diagnosis and refused therapeutic intervention. Although the adequacy of hemodialysis correlated with depression, it didn't reach statistical significance. Also, several relevant factors didn't correlate with depression, which may imply an independent endogenous origin of the disorder in hemodialysis patients. Conclusions: Depression is highly prevalent and under diagnosed among hemodialysis patients in Jordan, which is ironic with patient's negative attitude towards the diagnosis and its treatment. Hence, we recommend a policy of routine assessment of depression accompanied by an educational program to emphasize the importance of treatment in improving the quality of life and the overall outcome of hemodialysis therapy.