BACKGROUND: Depression is highly prevalent among patients undergoing hemodialysis in Arab countries, adversely affecting quality of life, treatment adherence, and clinical outcomes. Despite its significance, mental health issues remain underdiagnosed and undertreated due to cultural stigma, limited healthcare integration, and resource constraints. AIM: This systematic review aims to evaluate the prevalence, key predictors, and management challenges of depression among hemodialysis patients in Arab countries. METHOD: Following PRISMA guidelines, comprehensive searches of multiple databases were conducted for studies published from 2010 to June 2025. Inclusion criteria encompassed original quantitative, qualitative, and mixed-methods research focusing on depression in dialysis patients across Arab nations. Data extraction and quality assessment used standard tools, with a narrative synthesis employed to integrate findings due to heterogeneity. RESULTS: Analysis of 59 studies revealed a high prevalence of depression, averaging 55.6%, with rates ranging from 18% to 86.9%. Key predictors include female gender, older age, longer dialysis duration, low socioeconomic status, and comorbidities. Cultural stigma, lack of integrated mental health services, and limited provider training pose significant management barriers. DISCUSSION: The findings underscore the substantial mental health burden among dialysis patients, exacerbated by socio-cultural factors unique to the region. Addressing these challenges requires culturally sensitive screening, integrated psychosocial support, and healthcare system reforms to improve early diagnosis and treatment. CONCLUSION: Depression among hemodialysis patients in Arab countries is a critical public health issue, necessitating multidisciplinary, culturally tailored strategies to enhance mental health care, improve adherence, and elevate overall patient outcomes.
Qutishat et al. (Thu,) studied this question.