How Dialysis Patients Live: A Study on their Depression and Associated Factors in Southern Italy

Depression is an independent risk factor of poor outcomes for Chronic Kidney Disease (CKD) patients. Per-ceived social support and alexithymia are psychosocial variables identified by previous studies as predictive of depression in normal controls and CKD patients. Repetitively thinking and socially sharing emotional experi-ences have been investigated in association with depression in normal populations. Our cross-sectional study aimed to assess the effects of perceived social support, alexithymia, mental rumination, and social sharing on depression in CKD patients and controls. 103 CKD patients (age = 61.9 ± 7.2, 54 men) and 101 controls (age = 64.51 ± 6.56; 47 men) completed a questionnaire of 5 sections: Pluridimensional Inventory for Haemodialysis Patients (IPPE), Multidimensional Scale of Perceived Social Support (MSPSS), Geriatric Depression Scale (GDS), Toronto Alexihymia Scale (TAS-20), Social Sharing and Mental Rumination. Multiple regression analy-sis models with dummy variables assessed the effects of IPPE, MSPSS, TAS-20, Social Sharing, and Mental Rumination on GDS across the subgroups of participants. SPSS software was used. Depression levels resulted higher for patients than controls, especially in patients dialyzed for less than 4 years. The effects of perceived social support and alexithymia differed with respect to the subsamples. Rumination was positively associated with depression in normal controls, but negatively related with depression in patients dialyzed for 4+ years. The study confirmed high levels of depression in CKD patients. Depression was influenced by perceived social sup-port, alexithymia, and the cognitive elaboration of emotional troubles associated with the disease. Rumination appeared as a dysfunctional consequence of emotions for normal controls, but had an adaptive function for pa-tients dialyzed for 4+ years.