Patient mood flux on- and off-hemodialysis

Mood in hemodialysis patients is most often evaluated off-dialysis, possibly underestimating mood during dialysis. We compared mood in patients on- and off-dialysis using the Positive and Negative Affect Schedule for 6 consecutive days. Initially, scores are normal, but subsequently positive affect falls below, and negative affect increases above, off-dialysis values, suggesting increasing depression and anxiety, particularly in women. Quality-of-life questions confirm the effects of the dialysis session on mood. Prevalence and severity of depression evaluated off-dialysis, or once only, may be underestimated, especially in women, because hemodialysis patients undergo mood swings centering on the dialysis session. Focusing insight on the dialysis session could improve coping among patients and caretakers.