Original Article Screening for depression while patients dialyse: an evaluation

Background. The lack of routine depression screening among the haemodialysis (HD) population may contribute to depression being under-recognised. While screening pa-tients could be beneficial, the optimum screening procedure remains unclear. One method would be to screen HD pa-tients while they receive their treatment. The purpose of this investigation was to determine whether the Beck De-pression Inventory-II (BDI) could be administered while patients dialysed. Methods. Forty HD patients completed the BDI while dialysing and again at a time when off-dialysis. Level of agreement analysis (Bland and Altman) was undertaken to determine if the assessment condition influenced BDI scoring. The off-dialysis assessment also involved a short clinical interview that was compared with the BDI assess-ment. Results. There was a high level of agreement between the on- and off-dialysis assessments, but differences in response to the somatic items on theBDI scalewere apparent between the conditions. The clinical interview revealed that 22 % of the sample met the DSM-IV criteria for major depressive disorder. The optimal cut-off value for the BDI as deter-mined by receiver operating characteristic curves was≥16, with 88.9 % sensitivity and 87.1 % specificity. Conclusion. The results indicate that the procedure of on-dialysis assessment using the BDI is a viable screening pro-cedure. The practicality of employing this screening proce-dure may facilitate improved detection of depression in the dialysis population