eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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6/2020
vol. 16
 
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Psychiatry
abstract:
Systematic review/Meta-analysis

The influence of cognitive-behavioral therapy on depression in dialysis patients – meta-analysis

Pawel Zegarow
1
,
Malgorzata Manczak
1
,
Jacek Rysz
2
,
Robert Olszewski
1, 3

1.
Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
2.
Department of Nephrology, Hypertension and Family Medicine, University Clinical Hospital Military Memorial Medical Academy – Central Veterans’ Hospital, Lodz, Poland
3.
Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
Arch Med Sci 2020; 16 (6): 1271–1278
Online publish date: 2020/01/16
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Introduction
Depressive disorders are the most common mental health problem among patients undergoing dialysis. Furthermore, depression is an independent factor increasing the mortality and frequency of hospitalization in this group of patients, yet psychological intervention programs aimed at improving the mental health of dialysis patients have still not been developed. This meta-analysis aimed to assess the effects of cognitive-behavioral therapy on depressive symptoms in dialysis patients. The main hypothesis of this study is that cognitive-behavioral therapy is an effective psychological method of reducing the severity of depression symptoms among patients undergoing dialysis.

Material and methods
A systematic search was conducted using Medline, PubMed, Web of Science, Scopus and Google Scholar. Data extraction was carried out by two independent researchers. The severity of depression symptoms in the included studies was measured by the Beck Depression Inventory. A random-effects model was used to estimate the pooled mean difference of these values between patients undergoing CBT and the controls.

Results
Four of the 1841 search results met the inclusion criteria with data from 226 patients who had undergone dialysis therapy due to renal disorders and psychological intervention based on cognitive-behavioral therapy. This therapy significantly reduced the level of depression symptoms in all studies included in the meta-analysis (mean difference = –5.3, p = 0.001; 95% CI: –7.95 to –2.66).

Conclusions
The study showed that the use of psychological intervention based on cognitive- behavioral therapy was an effective method of decreasing the severity of depressive symptoms in hemodialyzed patients. For the sake of patient well-being, it seems reasonable to extend renal replacement therapy with psychological intervention such as cognitive-behavioral therapy.

keywords:

depression, dialysis, cognitive-behavioral therapy, renal replacement

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