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

Chilcot, Joseph and Almond, Michael K and Guirguis, Ayman and Friedli, Karin and Day, Clara and Davenport, Andrew and Wellsted, David and Farrington, Ken Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors. General hospital psychiatry, 54. pp. 31-36. ISSN 1873-7714.

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Abstract

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.

Item Type: Article
Subjects: WJ Urogenital system. Urology
WM Psychiatry. Mental health
Divisions: Emergency Services > Renal
Emergency Services > Therapies
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Depositing User: Beth Connors
Date Deposited: 12 Mar 2019 14:26
Last Modified: 12 Mar 2019 14:38
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1910

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