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Prognostic Utility of a Self-Reported Depression Questionnaire versus Clinician-Based Assessment on Renal Outcomes.

Publication ,  Journal Article
Jain, N; Carmody, T; Minhajuddin, AT; Toups, M; Trivedi, MH; Rush, AJ; Hedayati, SS
Published in: Am J Nephrol
2016

BACKGROUND: The prognostic utility of self-administered depression scales in chronic kidney disease (CKD) independent of a clinician-based major depressive disorder (MDD) diagnosis is neither clearly established nor are the optimal cutoff scores for predicting outcomes. The overlap between symptoms of depression and chronic disease raises the question of whether a cutoff score on a depression scale can be substituted for a time-consuming diagnostic interview to prognosticate risk. METHODS: The 16-item Quick Inventory of Depression Symptomatology-Self Report scale (QIDS-SR16) was administered to 266 consecutive outpatients with non-dialysis CKD, followed prospectively for 12 months for an apriori composite outcome of death or dialysis or hospitalization. Association of QIDS-SR16 best cutoff score, determined by receiver/responder operating characteristics curves, with outcomes was investigated using survival analysis. The effect modification of an interview-based clinician MDD diagnosis on this association was ascertained. RESULTS: There were 126 composite events. A QIDS-SR16 cutoff ≥8 had the best prognostic accuracy, hazards ratio (HR) = 1.77, 95% CI 1.24-2.53, p = 0.002. This cutoff remained significantly associated with outcomes even after controlling for comorbidities, estimated glomerular filtration rate, hemoglobin and serum albumin, adjusted HR (aHR) = 1.80, 95% CI 1.23-2.62, p = 0.002, and performed similarly to a clinician-based MDD diagnosis (aHR = 1.72, 95% CI 1.14-2.68). Adjustment for MDD conferred the association of QIDS-SR16 with outcomes no longer significant. CONCLUSIONS: QIDS-SR16 cutoff ≥8 adds to the prognostic information available to practicing nephrologists during routine clinic visits from comorbidities and laboratory data. This cutoff score performs similar to a clinician diagnosis of MDD and provides a feasible and time-saving alternative to an interview-based MDD diagnosis for determining prognosis in CKD patients.

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Published In

Am J Nephrol

DOI

EISSN

1421-9670

Publication Date

2016

Volume

44

Issue

3

Start / End Page

234 / 244

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Self Report
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • ROC Curve
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Jain, N., Carmody, T., Minhajuddin, A. T., Toups, M., Trivedi, M. H., Rush, A. J., & Hedayati, S. S. (2016). Prognostic Utility of a Self-Reported Depression Questionnaire versus Clinician-Based Assessment on Renal Outcomes. Am J Nephrol, 44(3), 234–244. https://doi.org/10.1159/000448598
Jain, Nishank, Thomas Carmody, Abu T. Minhajuddin, Marisa Toups, Madhukar H. Trivedi, Augustus John Rush, and S Susan Hedayati. “Prognostic Utility of a Self-Reported Depression Questionnaire versus Clinician-Based Assessment on Renal Outcomes.Am J Nephrol 44, no. 3 (2016): 234–44. https://doi.org/10.1159/000448598.
Jain N, Carmody T, Minhajuddin AT, Toups M, Trivedi MH, Rush AJ, et al. Prognostic Utility of a Self-Reported Depression Questionnaire versus Clinician-Based Assessment on Renal Outcomes. Am J Nephrol. 2016;44(3):234–44.
Jain, Nishank, et al. “Prognostic Utility of a Self-Reported Depression Questionnaire versus Clinician-Based Assessment on Renal Outcomes.Am J Nephrol, vol. 44, no. 3, 2016, pp. 234–44. Pubmed, doi:10.1159/000448598.
Jain N, Carmody T, Minhajuddin AT, Toups M, Trivedi MH, Rush AJ, Hedayati SS. Prognostic Utility of a Self-Reported Depression Questionnaire versus Clinician-Based Assessment on Renal Outcomes. Am J Nephrol. 2016;44(3):234–244.
Journal cover image

Published In

Am J Nephrol

DOI

EISSN

1421-9670

Publication Date

2016

Volume

44

Issue

3

Start / End Page

234 / 244

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Self Report
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • ROC Curve
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Middle Aged