Behavioral Therapy Found Effective for Treating Depression in Hemodialysis Patients

Depression is common among individuals on dialysis for kidney disease, but researchers have found that behavioral therapy can significantly improve these patients’ quality of life.

Patients undergoing hemodialysis are taxed both physically and mentally, and 20–30 percent become depressed. Many of these individuals are at increased risk of becoming hospitalized, developing other diseases, and even dying.

Ricardo Sesso, MD, and his colleagues at the Federal University of Sao Paulo, Brazil, set out to determine if psychological therapy might help these individuals. They studied 85 patients with end stage renal disease who were on hemodialysis and had been diagnosed with depression. Half of the patients underwent three months of weekly 90-minute sessions of cognitive-behavioral therapy that focused on strategies to cope with kidney disease treatment and its effects on daily life. The other half received routine dialysis care without behavioral interventions.

After three months, questionnaires were given to the participants, and the group receiving cognitive-behavioral therapy reported a significant improvement in quality of life compared with the control group. These differences persisted after six months of intervention.

“Cognitive-behavioral therapy is a relatively cheap, harmless, and practical intervention that improves depression, the main psychological problem of dialysis patients,” said Sesso.

Others noted that more research is needed to determine therapy’s effects on hospitalizations and mortality.

“This is an important study since it represents the first randomized controlled trial of therapy for depression of dialysis patients,” said Fred Finkelstein, MD, of the Renal Research Institute in New Haven, Conn. “Whether the improvement in depressive symptoms with cognitive-behavioral therapy translates into improved outcomes for patients in terms of mortality and hospitalizations remains to be determined.”

The study, “Effectiveness of a Cognitive-Behavioral Therapy in Hemodialysis Patients with Depression,” was part of the session on “Epidemiology, Outcomes, and Clinical Trials in Dialysis.”