Psychosocial interventions lift depression and improve QoL among CKD patients with depression

People with chronic kidney disease (CKD) treated with dialysis are frequently affected by depression. Psychotherapy has been reported to decrease depressive symptoms in various chronic diseases and is a potential treatment option for depression. We aimed to perform a systematic review and meta-analysis to evaluate the effect of psychotherapy on depression in adults with CKD. They searched MEDLINE, Embase, Web of Science, and Cochrane for published studies up to October 31, 2023. Two investigators independently reviewed the included studies and extracted relevant data. Randomized controlled trials (RCTs) assessing the impact of interventions that provide psychological, emotional, or social support without the use of pharmacological substances on depressive symptoms in people with CKD were included and summarized. Scores on different tools for depressive assessment and quality of life were pooled. Results: 19 RCTs published between 2004 and 2023 were included and analyzed. The weighted mean difference (WMD) for all included studies concerning depression was − 2.32.

The WMD for the Beck Depression Inventory (BDI) score of depression was − 3.27 with significant heterogeneity. Significant WMD was detected for the Hospital Anxiety and Depression Scale (HADS) tool: WMD=-1.90, 95%CI=-2.91, -0.90, P < 0.001. The WMD for all included studies regarding quality of life was 1.21 (95%CI=-0.51, 2.93, P = 0.168). The WMD for Kidney Disease Quality of Life Short Form (KDQOL-SF) score was 4.55. The WMD for SF-36 score was 0.02. A significant difference in outcomes of the S-PRT scale was observed. Psychosocial interventions probably reduce the depression level among CKD patients. Preliminary evidence suggests that psychosocial interventions might be beneficial for the quality of life in CKD patients. The results give medical facilities an evidence-based basis for establishing psychosocial interventions in kidney care settings.

Reference: Yang, H., Qi, L. & Pei, D. Effect of psychosocial interventions for depression in adults with chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol 25, 17 (2024). https://doi.org/10.1186/s12882-023-03447-0