Cochrane · systematic review · CD004542
Psychosocial interventions for preventing and treating depression in dialysis patients
Natale, P, Palmer, SC, Ruospo, M, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
35
current version
GRADE rated
10
No studies
25
Included studies
NR
No studies 25 · 71.4%Ungraded 0 · 0%Very low 1 · 2.9%Low 5 · 14.3%Moderate 4 · 11.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cognitive‐behavioural therapy versus usual care
Population: people with ESKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major depression Mini International Neuropsychiatric Interview (MINI) (median Cognitive‐behavioural therapy vs usual care | no estimate extracted | NR | No studies |
Depression (any severity, including mild, moderate and severe depression) Investigators measured depression using the Beck Depression Inventory (BDI). A higher score is indicative of more depressive symptoms. (median Cognitive‐behavioural therapy vs usual care | no estimate extracted | 4 studies · 230 participants | Moderate Downgraded: risk of bias, imprecision |
Health‐related quality of life Investigators measured health‐related quality of life using different instruments: Quality of Life Scale (QoL) and HRQoL Short Form‐36, Kidney Disease and Quality of Life‐Short Form (KDQOL‐SF‐36) (median Cognitive‐behavioural therapy vs usual care | SMD 0.51 [0.19, 0.83] | 4 studies · 230 participants | Moderate Downgraded: risk of bias, imprecision |
Anxiety Beck Anxiety Inventory (BAI) (median Cognitive‐behavioural therapy vs usual care | no estimate extracted | NR | No studies |
Withdrawal from dialysis Cognitive‐behavioural therapy vs usual care | no estimate extracted | NR | No studies |
Withdrawal from intervention Cognitive‐behavioural therapy vs usual care | no estimate extracted | NR | No studies |
Death (any cause) (median Cognitive‐behavioural therapy vs usual care | RR 1.09 [0.35, 3.45] | 2 studies · 145 participants | Low Downgraded: risk of bias, imprecision |
Counselling versus usual care
Population: people with ESKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major depression Counselling vs usual care | no estimate extracted | NR | No studies |
Depression (any severity, including mild, moderate and severe depression) Investigators measured depression using the Beck Depression Inventory (BDI). A higher score is indicative of more depressive symptoms. (median Counselling vs usual care | no estimate extracted | 3 studies · 99 participants | Low Downgraded: risk of bias, imprecision |
HRQoL Kidney Disease Quality of Life (KDQOL‐36) (median Counselling vs usual care | no estimate extracted | NR | No studies |
Anxiety Counselling vs usual care | no estimate extracted | NR | No studies |
Withdrawal from dialysis Counselling vs usual care | no estimate extracted | NR | No studies |
Withdrawal from intervention (median Counselling vs usual care | no estimate extracted | NR | No studies |
Death (any cause) (median Counselling vs usual care | RR 1.69 [0.32, 8.81] | 2 studies · 270 participants | Low Downgraded: risk of bias, imprecision |
Exercise versus usual care
Population: people with ESKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major depression (median Exercise vs usual care | RR 0.47 [0.27, 0.81] | 3 studies · 108 participants | Low Downgraded: risk of bias, imprecision |
Depression (any severity, including mild, moderate and severe depression) Investigators measured depression using the Beck Depression Inventory (BDI). A higher score is indicative of more depressive symptoms (median Exercise vs usual care | no estimate extracted | 3 studies · 108 participants | Moderate Downgraded: risk of bias, imprecision |
HRQoL Investigators measured health related quality of life using the Quality of Life Index (QLI). A higher score is indicative of higher perceived of QoL (median Exercise vs usual care | MD 3.06 [2.29, 3.83] | 2 studies · 64 participants | Low Downgraded: risk of bias, imprecision |
Anxiety Hospital Anxiety and Depression Scale (HADS) (median Exercise vs usual care | no estimate extracted | NR | No studies |
Withdrawal from dialysis Exercise vs usual care | no estimate extracted | NR | No studies |
Withdrawal from intervention Exercise vs usual care | no estimate extracted | NR | No studies |
Death (any cause) Exercise vs usual care | no estimate extracted | NR | No studies |
Relaxation techniques versus usual care
Population: people with ESKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major depression Relaxation techniques vs usual care | no estimate extracted | NR | No studies |
Depression (any severity, including mild, moderate and severe depression) Investigators measured depression using the Beck Depression Inventory (BDI). A higher score is indicative of more depressive symptoms. (median Relaxation techniques vs usual care | no estimate extracted | 2 studies · 122 participants | Moderate Downgraded: risk of bias, imprecision |
HRQoL Investigators measured health‐related quality of life using the Health Status Questionnaire Short Form (SF‐36) (median Relaxation techniques vs usual care | no estimate extracted | NR | No studies |
Anxiety Relaxation techniques vs usual care | no estimate extracted | NR | No studies |
Withdrawal from dialysis Relaxation techniques vs usual care | no estimate extracted | NR | No studies |
Withdrawal from intervention Relaxation techniques vs usual care | no estimate extracted | NR | No studies |
Death (any cause) Relaxation techniques vs usual care | no estimate extracted | NR | No studies |
Spiritual practice versus usual care
Population: people with ESKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major depression Spiritual practice vs usual care | no estimate extracted | NR | No studies |
Depression (any severity, including mild, moderate and severe depression) Investigators measured depression using different instruments: Beck Depression Inventory (BDI) and Brief Symptom Inventory (BSI). A higher score is indicative of more depres... Spiritual practice vs usual care | no estimate extracted | 2 studies · 116 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Health‐related quality of life Health Status Questionnaire Short Form (SF‐36) (median Spiritual practice vs usual care | no estimate extracted | NR | No studies |
Anxiety Brief Symptom Inventory (BSI) (median Spiritual practice vs usual care | no estimate extracted | NR | No studies |
Withdrawal from dialysis Spiritual practice vs usual care | no estimate extracted | NR | No studies |
Withdrawal from intervention Spiritual practice vs usual care | no estimate extracted | NR | No studies |
Death (any cause) Spiritual practice vs usual care | no estimate extracted | NR | No studies |