Introduction: Pneumonia of unknown cause was detected on 30 December 2019 in China. It was categorized as an outbreak and named as COVID-19 by the World Health Organization. The pandemic affects all people, but patient groups such as hemodialysis (HD) patients have been particularly affected. We do not know if refugees suffered more during the outbreak. In this study, we compared depressive symptom frequency between Syrian refugee HD patients and Turkish ones.

Methods: The study had a single-center, cross-sectional design. Demographic and clinical data were collected retrospectively from patients’ files containing details about past medical history, demographic variables and laboratory values. Validated Turkish and Arabic forms of Beck Depression Inventory (BDI) were used to assess depressive symptoms. BDI scores were compared according to nationality, demographic features and clinical data. A BDI score more than 14 was accepted as suspicion of depression.

Results: 119 patients were enrolled in the study. After the exclusion of 22 patients, 75 Turkish and 22 Syrian patients were included for further analysis. The median BDI (interquartile range) score for Turkish and Syrian patients were 12 (7-23) and 19.5 (12.7-25.2), respectively (p=0.03). Suspicion of depression was present at 42.7% of Turkish, and 72.7% of Syrian HD patients (p=0.013). Regarding all patients, phosphorus level, Kt/V, and nationality were significantly different between patients with and without suspicion of depression (p=0.023, 0.039, 0.013, respectively).

Conclusion: Syrian patients had higher BDI scores and more depressive symptoms than Turkish patients. Additional national measures for better integration and more mental support to Syrian HD patients are needed. 

Demographic data were collected retrospectively from patients’ files. Age, sex, nationality, marital status, education level, height, weight, etiology of kidney disease, the date for initiation of center HD, last hemoglobin, albumin, phosphorus, parathyroid hormone, Kt/v, creatinine levels, Charlson comorbidity index were noted. Marital status was grouped as married and others including single, divorced, and widow.

BDI consists of 21 questions and every question has four choices pointed from 0 to 3 in which 0 represents the absence of a problem, and 3 represents an extreme problem. Therefore, the total BDI score can be between 0 and 63 points. BDI score of more than 14 was accepted as depression in patients with end-stage renal disease (ESRD). The frequency of depression was compared between nationalities.  Validated Turkish and Arabic BDI forms were filled by patients themselves. In the need of help, native Arabic physician working at our hemodialysis center (SS) and official Arabic translator of our institution (SA) have helped Syrian patients. BDI score was also divided into cognitive-affective and somatic-performance subscales. These were compared to nationality as well. 

BDI score was compared according to the age groups (<65 years or ≥65 years), sex, education level, marital status, body mass index (<25 kg/m², 25-30 kg/m², >30 kg/m² ), presence of diabetes mellitus, presence of hypertension, HD vintage (below or above median), hemoglobin level (<10 g/dl, 10-12 g/dl, >12 g/dl), phosphorus level (<3.5 mg/dl, 3.5-5.5 mg/dl, >5.5 mg/dl), albumin level (<3.5 gr/dl or ≥3.5 gr/dl), parathyroid hormone level (below or above median), Kt/v (<1.4 or ≥1.4), and nationality.

This file was generated on 2020-12-17 by MUSTAFA SEVINC

GENERAL INFORMATION

1. Title of Dataset: Frequency of depressive symptoms in Syrian refugees and Turkish maintenance hemodialysis patients during COVID-19 pandemic

2. Author Information
     Principal Investigator Contact Information
        Name: Mustafa Sevinc
        Institution: Sisli Hamidiye Etfal Education and Training Hospital
        Address: Halaskargazi Caddesi Etfal Sokak 34371, Sisli, Istanbul, Turkey
        Email: musevinc@hotmail.com

3. Date of data collection: Between 2020-04-17 and 2020-05-12 

4. Geographic location of data collection: Istanbul, Turkey

5. Information about funding sources that supported the collection of the data: None

SHARING/ACCESS INFORMATION

1. Licenses/restrictions placed on the data: subjects' height and weight, renal replacement initiation date, nationality, although collected, were removed and is not missing from the data file. 

DATA & FILE OVERVIEW

1. File List: Frequency of depressive symptoms in Syrian refugees and Turkish maintenance hemodialysis patients during COVID-19 pandemic: This is the main file cantaining variables used in this study. 
2. Additional related data collected that was not included in the current data package: some variables listed above were removed for anonymization.

3. Are there multiple versions of the dataset? No

METHODOLOGICAL INFORMATION

1. Description of methods used for collection/generation of data: 

• Participants signed written consent forms both to participate in the study and to have data from their medical records used in research.  
• All HD patients in the same center were invited to participate in the study. 
• Exclusion criteria were as follows: patients younger than 18 years old, patients undergoing home-HD, history of HD less than three months, 
  inability to complete the questionnaire, nationalities other than Turkish and Syrian, not volunteering to fill the form, history of hospitalization due to any reason during pandemic time starting from 10 March 2020, and history of COVID-19 before questionnaire.
• Demographic data were collected retrospectively from patients’ files. 
• These files contain the demographic details of patients filled at admission to our dialysis center and patients’ past and current laboratory values.
• Age, sex, nationality, marital status, education level, height, weight, etiology of kidney disease, the date for initiation of center HD, last hemoglobin, albumin, phosphorus, parathyroid hormone, Kt/v, creatinine levels and, Charlson comorbidity index were noted. 
• Marital status was grouped as married and not married including single, divorced, and widow. 
• BDI consists of 21 questions and every question has four choices ranging from 0 to 3 in which 0 represents the absence of a problem, and 3 represents an extreme problem. Therefore, the total BDI score can be between 0 and 63 points. 
  BDI score of more than 14 was accepted as suspicion of depression in patients with end-stage renal disease (ESRD). 
• The frequencies of depressive symptoms were compared between nationalities. The validated Turkish and Arabic forms of BDI version- I were filled by patients themselves. 
• BDI score was compared according to age group (<65 years or ≥65 years), sex, education level, marital status, body mass index (<25 kg/m2, 25-30 kg/m2, >30 kg/m2 ), 
  presence of diabetes mellitus, presence of hypertension, HD vintage (below or above median), hemoglobin level (<10 g/dl, 10-12 g/dl, >12 g/dl), phosphorus level (<3.5 mg/dl, 3.5-5.5 mg/dl, >5.5 mg/dl), albumin level (<3.5 gr/dl or ≥3.5 gr/dl), parathyroid hormone level (below or above median), Kt/v (<1.4 or ≥1.4), and nationality. 
• BDI score was also divided into cognitive-affective and somatic-performance subscales [12]. These were compared to nationality as well.  

2. Methods for processing the data: 

• Statistical analyses were performed with the Scientific Package for Social Science (version 21.0; SPSS Inc., Chicago, IL, USA). 
• Continuous variables were given as mean ± standard deviation if they were distributed normally or as median (interquartile range) if they were distributed abnormally.  
• Qualitative variables were given as a percentage. A comparison of normally distributed data was performed by independent samples t-test. 
• Abnormally distributed data was compared with the Mann-Whitney U test. Categorical variables were compared by the Chi-Square test. 
• Differences were considered statistically significant for p values less than 0.05.

DATA-SPECIFIC INFORMATION FOR: [Frequency of depressive symptoms in Syrian refugees and Turkish maintenance hemodialysis patients during COVID-19 pandemic]

1. Number of variables: 65

2. Number of cases/rows: 97

3. Variable List: 

• patient_number: Patient number
• RRT_type: Renal replacement therapy type
• total_BDI_score: total beck depression inventory score
• somatic_subscore: total somatic subscore
• affective_cognitive_subscore: affective/cognitive subscore
• bdi_group: beck depression inventory group according to score of 14
• age_group_for_65: age grouped for 65 years
• age_group: age grouped for less than 50, 50-69, 60-69, 70-79, >79 years
• married_or_not: married or other status
• kidney_disease_etiology: etiology of end stage renal failure
• Diabetes_status: diabetes mellitus status grouped as absent, present and uncomplicated, present and complicated
• Diabetes_yes_no: diabetes present or absent
• hypertension: hypertension present or absent
• hemoglobin: last hemoglobin level
• hemoglobin_group: hemoglobin level grouped for 10 or less, more than 10-12, more than 12
• albumin: last albumin level
• albumin_group: albumin level grouped as 3.5 or less and more than 3.5
• phosphorus: last phosphorus level
• phosphorus_group: phosphorus group
• pth: parathyroid hormone level
• pth_group: parathyroid hormone grouped for median level 
• ktv: last kt/v
• ktv_group: kt/v grouped for 1.4 or less and more than 1.4
• creatinine: last creatinine level
• bmi_group: body mass index grouped as 25 or less, >25-30, more than 30.   
• question_1: Beck depression inventory question 1
• question_2: Beck depression inventory question 2
• question_3: Beck depression inventory question 3
• question_4: Beck depression inventory question 4
• question_5: Beck depression inventory question 5
• question_6: Beck depression inventory question 6
• question_7: Beck depression inventory question 7
• question_8: Beck depression inventory question 8
• question_9: Beck depression inventory question 9
• question_10: Beck depression inventory question 10
• question_11: Beck depression inventory question 11
• question_12: Beck depression inventory question 12
• question_13: Beck depression inventory question 13
• question_14: Beck depression inventory question 14
• question_15: Beck depression inventory question 15
• question_16: Beck depression inventory question 16
• question_17: Beck depression inventory question 17
• question_18: Beck depression inventory question 18
• question_19: Beck depression inventory question 19
• question_20: Beck depression inventory question 20
• question_21: Beck depression inventory question 21
• hd_vintage_days: hemodialysis vintage in days
• hd_vintage_months: hemodialysis vintage in months
• hd_vintage_year: hemodialysis vintage in years
• hdvintigae_median_group: hemodialysis vintage grouped as below or above median value
• MI_history: myocardial infarction history present or absent
• Heart_faillure: heart failure history present or absent
• Perip_vasc_dis: peripheral vascular disease history present or absent
• stroke: stroke history present or absent
• dementia: dementia history present or absent
• COPD: Chronic pulmonary obstructive disease history present or absent
• conn_tis_dis: connective tissue disease history present or absent
• peptic_ulcer: peptic ulcer history present or absent
• liver_dis: lever disease history present or absent
• hemiplejia: hemiplejia history present or absent
• CKD: Chronic kidney disease history present or absent
• solid_tm: solid tumor history present or absent
• leukemia: leukemia history present or absent
• lymhoma: lymphoma history present or absent
• CCMI: Charlson comorbidity index