Using depression screening tools in patients with kidney failure

"Our hope was that we'd find evidence that pointed to an optimal screening tool. This was optimistic of course, for if there was one that had strong evidence, it would already be in use," said Dr. Kondo. "We also hoped that the we'd find some evidence to support the use of the tools that are common in practice. And we didn't. The PHQ-2 and -9 are widely used in medical settings and are free. The CES-D is another that is commonly used. We found only one study each of the PHQ-9 and the CES-D, and no studies of the PHQ-2."

Dr. Kondo noted that many of the studies were conducted overseas, and it's unclear how applicable they are to patients in the United States. Many of the studies were small, and among the studies examining the same tools, there wasn't much agreement in the cutoff values chosen to define depression and its severity.

An accompanying editorial notes that there are multiple practical considerations to take into account when considering the best screening tool to identify depression in patients with kidney failure on dialysis.

A Patient Voice also accompanies the study and provides the perspective of a veteran with kidney disease who was diagnosed with depression through the PHQ-9 tool.