Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors

Copyright © 2018 Elsevier Inc. All rights reserved.Objective: To validate the factor structure of two common self-report depression tools in a large sample of haemodialysis (HD) patients and to examine their demographic and clinical correlates, including urine output, history of depression and transplantation. Methods: Factor structures of the Beck Depression Inventory (BDI-II) and Patient Health Questionnaire (PHQ-9) were evaluated using confirmatory factor analysis (CFA). Data was utilised from the screening phase (n = 709) of a placebo-controlled feasibility randomised control trial (RCT) of sertraline in HD patients with mild to moderate Major Depressive Disorder. Alternative factor models including bi-factor models for the BDI-II and PHQ-9 were evaluated. Coefficient omega and omega-hierarchical were calculated. Results: For both measures, bi-factor measurement models had the overall best fit to the data, with dominant general depression factors. Omega-hierarchical for the general BDI-II and PHQ-9 factors was 0.94 and 0.88 respectively. Both general factors had high reliability (coefficient omega = 0.97 and 0.94 respectively) and explained over 85% of the explained common variance within their respective models. BDI-II and PHQ-9 general depression factors were negatively associated with age and urine output and positively with a history of depression, antidepressant use within the last 3 months and a history of failed transplantation. In adjusted regression models, age, urine output and a history of depression remained significant. Conclusions: These data suggest that both the BDI-II and PHQ-9 are sufficiently unidimensional to warrant the use of a total score. Younger age, lower urine output and a history of depression appear consistent correlates of depression severity among HD patients.Peer reviewedFinal Accepted Versio

Brief report: self-compassion, physical health and the mediating role of health-promoting behaviours

To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours (R(2) = 0.13, b = -8.98, p = 0.015), which was partially mediated through health-promoting behaviours (R(2) = 0.06, b = -3.16, 95 per cent confidence interval [-6.78, -0.86]). Findings underscore the potential health-promoting benefits of self-compassion.non

Postdialysis recovery time is extended in patients with greater self-reported depression screening questionnaire scores

© 2018 International Society for HemodialysisIntroduction: Most patients take time to recover after a hemodialysis (HD) session. It has been suggested that recovery time is associated with intradialytic hypotension and rapid solute clearances. Other studies have reported a linkage to depression. We investigated the association between recovery time and intradialytic hypotension and depression. Methods: In five UK HD units, we screened for depressive symptoms using the Beck depression inventory-II, Patient Health Questionnaire, and recorded sessional blood pressures and Kt/Vurea. Findings: Seven hundred and one HD patients were studied; 63.6% male, mean age 64.1 ± 16.6 years, 33.5% diabetic. About 24.1% recovered in 1 hour were more likely to be female, have high self-reported Beck depression inventory-II scores, a past medical history of depression, and be living without a partner. Longer recovery times were also associated with very low postdialysis systolic blood pressures (<100 mmHg), and higher body weight. However, the model predicted only 18% of the variation in recovery times. We found no association between recovery times and short-term mortality risk. Discussion: Prolonged postdialysis recovery times are associated with higher self-reported depression scores, and very low postdialysis blood pressure. Future studies investigating changes in dialysis practice and recovery times will need to target strategies to prevent intradialytic hypotension and adjust for patient psychological status.Peer reviewedFinal Accepted Versio

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Self-reported antidepressant use in haemodialysis patients is associated with increased mortality independent of concurrent depression severity

© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).Peer reviewe

Psychological Distress in Women Living with Polycystic Ovary Syndrome (PCOS): The Role of Illness Perceptions

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic condition linked to increased risk of anxiety and depression (psychological distress). This study examined the relationship between illness perceptions and psychological distress in women living with PCOS. Methods: We used a cross-sectional survey to assess psychological distress (Hospital Anxiety and Depression Scale) and illness perceptions (Illness Perception Questionnaire-Revised) in women living with PCOS in the UK (N = 487). Hierarchical multiple linear regression tested the associations between illness perceptions and psychological distress, adjusting for age, years since PCOS diagnosis, education, body mass index, current depression, and current anxiety disorder. Results: In the fully adjusted regression model, illness perceptions explained 18.6% of the variance in psychological distress, F(7,458) = 21.0, p < .001. Reporting more symptoms (B = 0.226), higher perceived consequences (B = 0.204), lower personal control (B = –0.184), and lower illness coherence (B = –0.127) were significantly associated with higher psychological distress (all p < .001). Conclusions: Illness perceptions may play an important role in psychological distress, even after adjusting for relevant demographics and clinical characteristics. Our findings highlight key areas where researchers and clinicians could develop targeted self-management interventions for women with PCOS, focused on altering maladaptive illness perceptions to reduce psychological burden

Brief report: Self-compassion, physical health and the mediating role of health-promoting behaviours.

To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours (R(2) = 0.13, b = -8.98, p = 0.015), which was partially mediated through health-promoting behaviours (R(2) = 0.06, b = -3.16, 95 per cent confidence interval [-6.78, -0.86]). Findings underscore the potential health-promoting benefits of self-compassion

Expressive writing, self-criticism and self-reassurance

Self-criticism and reassurance are important mechanisms for regulating negative emotions but relatively little attention has been paid to interventions aimed at improving them. This study explored the use of an expressive writing task to increase self-reassurance and reduce self-criticism using a randomized controlled design.Peer reviewedSubmitted Versio