Distinct Depression Symptom Trajectories over the First Year of Dialysis: Associations with Illness Perceptions

BACKGROUND: Depression in the dialysis population is common, but trajectories of depression symptoms are unknown. PURPOSE: This study aims to (1) examine whether different patterns of depression symptoms exist over the first year of dialysis and (2) to understand if illness perceptions are associated with observed trajectories of depression symptoms. METHOD: Incident dialysis patients (n = 160) completed the Beck Depression Inventory II and the Revised Illness Perception Questionnaire soon after starting dialysis and again at 6 and 12 months. Latent class growth modelling identified distinct groups of depression symptom trajectories. RESULTS: Three depression trajectories were identified: "low-reducing" (62 %), "moderate-increasing" (21.8 %) and "high-reducing" (16.2 %). Higher levels of depression were associated with a poorer understanding of the illness (coherence) and perceptions that kidney failure has severe consequences and a more cyclical timeline. Beliefs that treatment controlled kidney failure decreased over time in patients with increasing depression symptoms. CONCLUSION: Distinct patterns of depression symptoms are associated with illness perceptions. The potential to identify common patterns of depression symptoms may help target treatments at those most likely to benefit.