Depression, Alexithymia and Long-Term Mortality in Chronic Hemodialysis Patients

作者：Kojima Masayo^*; Hayano Junichiro; Suzuki Sadao; Seno Hachiro; Kasuga Hirotake; Takahashi Hiroshi; Toriyama Takanobu; Kawahara Hirohisa; Furukawa Toshiaki A

来源：Psychotherapy and Psychosomatics, 2010, 79(5): 303-311.

DOI：10.1159/000319311

• Alexithymia
• Depression
• Epidemiology
• Mortality
• Prognostic factors
• Hemodialysis

Background: Depression increases the risk of mortality in hemodialysis patients. Alexithymia, a disorder of affect regulation, has also been reported to be associated with mortality risk in the general population. We conducted a prospective study to estimate the independent impact of depression and alexithymia on long-term mortality. Methods: A total of 230 hemodialysis outpatients, with a mean age of 56.3 +/- 9.6 years, completed a batch of self-report measures including the Beck Depression Inventory-II (BDI-II), the 20-item Toronto Alexithymia Scale (TAS-20) and the 36-item Short Form Health Survey (SF-36). Survival status was confirmed every 6 months for up to 5 years. The presence of depression and alexithymia was defined by a BDI-II score of >= 14 and a TAS-20 score of >= 61, respectively. Results: During the follow-up period, 27 deaths were confirmed. Both depression and alexithymia were associated with an increased risk for all-cause mortality; the age-and sex-adjusted hazard ratio for depression was 2.36 (95% CI: 1.08-5.15; p = 0.03) and that for alexithymia was 4.29 (95% CI: 1.95-9.42; p < 0.001). Depression lost its statistical significance after controlling for alexithymia, whereas alexithymia remained significant even after adjusting for the baseline depression, health status (the summary scores of the SF-36), marital status and clinical covariates (multivariate adjusted hazard ratio = 3.62; 95% CI: 1.32-9.93; p = 0.01). Conclusions: Alexithymia is a strong independent risk factor for all-cause mortality in hemodialysis patients.

• 出版日期2010