THE DIAGNOSIS OF MAJOR DEPRESSION IN END-STAGE RENAL-DISEASE

Background: Although major depression commonly occurs in medically ill patients, it can be difficult to diagnose since depression and many m edical illnesses share common physical symptoms. Methods: This study w as designed to evaluate patients with end-stage renal disease (ESRD) f or major depressive disorder using three diagnostic approaches, to ass ess the Beck Depression Inventory as a screening instrument for major depression, and to examine the association of anhedonia with a diagnos is of major depression in ESRD patients who deny depressed mood. Resul ts: Rates of major depression varied from 6 to 34% according to the cr iteria that were used. The sensitivity of the Beck Depression Inventor y was found to be modest. Anhedonia was a helpful clue for diagnosing depression in patients who denied depressed mood. Conclusions:The find ings illustrate the current difficulties in applying DSM criteria for major depression to medical patients and underscore the need for more specific guidelines.