Diagnostic and treatment considerations in depressed dialysis patients.

Depressive symptoms are common in a dialysis population. These symptoms are only infrequently part of a major depressive illness, however, and are more usually related to adjustment disorders associated with the onset of chronic dialysis treatment, or medical complications of end stage renal disease. A substantial proportion of depressive symptoms are also related to problems in living not directly associated with renal failure. Psychotherapeutic support helps the majority of patients with depressive symptomatology. Nurse-patient and physician-patient relationships are potentially powerful factors influencing patient adjustment to dialysis.