ArticleKidney medicine
Psychological Flexibility and Depression in Advanced CKD and Dialysis.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Effects of exercise dose based on the ACSM recommendations on depression in hemodialysis patients: a systematic review and meta-analysis of randomized controlled trials.Frontiers in physiology · 2024Pooled it
- Depression and Advance Care Planning Among Japanese Patients Undergoing Hemodialysis: Japanese Dialysis Outcomes and Practice Pattern Study (J-DOPPS).Kidney medicine · 2026Article
- The dynamic association between depression, psychological flexibility, and meaning in life among medical students: a cross-lagged analysis.BMC psychology · 2025Article
- Effect of Acceptance and Commitment Therapy on Malnutrition, Psychological Flexibility, and Emotional Well-being in Patients Undergoing Peritoneal Dialysis: A Randomized Controlled Study.Psychiatry and clinical psychopharmacology · 2025Article
- Inverse associations of the lifestyle critical 9 with cardiorenal syndrome: the mediating role of the dietary inflammatory index.Frontiers in nutrition · 2025Article
- Dose-dependent association between estimated glomerular filtration rate and the subsequent risk of depression: An analysis of a nationwide epidemiological dataset.European journal of clinical investigation · 2025Article
- Association between health-related hope and distress from restrictions in chronic kidney disease and dialysis.BMC nephrology · 2024Observational
- Comprehensive geriatric assessment of older patients with renal disease: a cross-sectional survey.Scientific reports · 2024Article
- Association Between Serum Magnesium Levels and Depression in Patients Undergoing Peritoneal Dialysis: A Study Conducted at Handan First Hospital, China.Psychology research and behavior management · 2024Article
- Giving Meaning to Non-Communicable Illness: Mixed-Method Research on Sense of Grip on Disease (SoGoD).Healthcare (Basel, Switzerland) · 2022Article
- Article
- The Relation between Negative Automatic Thoughts and Psychological Inflexibility in Schizophrenia.Journal of clinical medicine · 2022Article
- Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
RATIONALE &
objectiveDepression is prevalent and highly associated with mortality among patients with chronic kidney disease (CKD). Psychological flexibility can be captured as acceptance in psychology, and its improvement by behavioral therapy is associated with reduced depression in some clinical settings. However, no study has been reported on patients with CKD. This study aimed to examine the association between psychological flexibility and depression in patients with CKD. STUDY
designCohort study. SETTING &
participantsThis multicenter study of 5 hospitals in Japan included patients with nondialysis stage 3-5 CKD or stage 5D CKD receiving hemodialysis or peritoneal dialysis. PREDICTOR: Psychological flexibility measured using the 7-item Acceptance and Action Questionnaire (AAQ-II). OUTCOMES: The prevalence and incidence of depression after 1 year, which was defined by a score ≥ 16 points on the Center for Epidemiologic Studies Depression (CES-D) questionnaire. ANALYTICAL APPROACH: Gamma regression was used in the examination of correlates of the psychological flexibility value. Modified Poisson regression models were fit for the prevalence and incidence of depression.
resultsThe cross-sectional and longitudinal analyses included 433 and 191 patients, respectively. Lower (ie, worse) psychological flexibility levels were associated with hemodialysis and peritoneal dialysis. Higher (ie, better) psychological flexibility levels were associated with lower prevalence of depression (per 5-point increase; adjusted prevalence ratio, 0.75; 95% CI, 0.70-0.80) and lower incidence of depression (per 5-point increase; adjusted risk ratio, 0.72; 95% CI, 0.61-0.85). LIMITATIONS: Depression was assessed using the CES-D questionnaire. Cultural differences may exist in the interpretation of AAQ-II scores.
conclusionsBetter psychological flexibility was associated with lower prevalence and incidence of depression in patients with CKD. Further studies are warranted to determine the possible prevention and treatment of depression by the development of behavioral interventions to improve psychological flexibility.
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