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Depressive disorders in children with chronic kidney disease treated conservatively
Katarzyna Kiliś-Pstrusińska1, Anna Medyńska1, Piotr Adamczyk2
1Clinical Department of Pediatric Nephrology, Wroclaw Medical University, Poland.
Insights
Depression is a significant concern for children with chronic kidney disease (CKD). Factors like diagnosis age, disease duration, and CKD stage progression are linked to depressive symptoms.
Area of Science:
- Pediatric Nephrology
- Child and Adolescent Psychiatry
- Mental Health Research
Background:
- Children with chronic kidney disease (CKD) face substantial mental and emotional stress, increasing the risk of depressive disorders.
- The prevalence of depressive disorders in pediatric CKD populations ranges from 7% to 35%.
Purpose of the Study:
- To determine the prevalence and characteristics of depression and depressive symptoms in children and adolescents with CKD receiving conservative treatment.
- To investigate factors associated with depressive symptoms in this vulnerable population.
Main Methods:
- A cross-sectional, multicenter study involving 73 children (aged 8-18) with CKD and 92 parents.
- Utilized Kovacs's Children's Depression Inventory 2 (CDI2) - Self-Report and Parent Form to assess mental well-being.
Main Results:
- 11% of participants reported symptoms suggestive of depressive disorder, with 8.2% meeting depression criteria.
- Significant correlations found between age, age at diagnosis, CKD duration, and various depression subscales (interpersonal problems, ineffectiveness, emotional problems).
- Depressive symptoms varied significantly between CKD stages III and IV, with notable child-parent disagreement on symptom reporting.
Conclusions:
- Depression is a prevalent issue in children with CKD undergoing conservative treatment.
- Age at diagnosis, disease duration, and CKD progression (stage III to IV) appear to be key predisposing factors for depression.
- Multidimensional assessment is crucial for diagnosing depression due to observed disparities between child self-reports and parental assessments.
Background:
Children with chronic kidney disease (CKD) experience a lot of mental and emotional stress, which can lead to the development of depressive disorders. The prevalence of depressive disorders in CKD children is estimated to be between 7% and 35%.
Objectives:
The aim of our study was to analyze the prevalence and characteristics of depression and depressive symptoms in children and adolescents with CKD treated conservatively.
Material And Methods:
The cross-sectional, multicenter study was conducted in 73 CKD children aged 8-18 and in 92 of their parents. To assess the mental wellbeing of CKD children, Kovacs's Children's Depression Inventory 2 (CDI2) was used as CDI2: Self-Report and CDI2: Parent Form.
Results:
The majority of CKD children acquired medium scores in CDI2, 11% of participants reported symptoms suggesting depressive disorder, and among them 8.2% met the criteria for depression. A significant relationship was found between age and interpersonal problems, age at CKD diagnosis, and total score and ineffectiveness, CKD duration and total score/emotional problems. Depressive symptoms were associated with the stage of CKD, and they differed significantly between stages III and IV. We noticed the child-parent disagreement on reported depressive symptoms. Parents perceive their children's mental state as worse than the children themselves.
Conclusions:
There is a problem of depression in children with CKD treated conservatively. Variables associated with depressive symptoms in CKD children treated conservatively require further study. Key factors predisposing to the development of depression seem to be age at the time of diagnosis, disease duration, and progression of CKD from stage III to IV. Disparities between depressive symptoms self-reported by CKD children and their parents' assessment require further analysis. However, these disparaties indicate that the final diagnosis of the occurrence of depressive disorders should be based on a multidimensional assessment of the patient's situation.
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