Chronic kidney disease and emotional-behavioral disorders in adolescents
Abstract
Background Chronic kidney disease (CKD) is characterized by progressive renal injury with inevitable functional deterioration. This functional loss is usually slow, progressive, and irreversible. Chronic kidney disease profoundly influences the daily routines of pediatric patients and their families, requiring significant psychosocial adaptation by both patients and families.
Objective To assess for potential associations between CKD and emotional/behavioral disorders in adolescents.
Methods This cross-sectional study was done at the Pediatric Nephrology Outpatient Department, Hasan Sadikin Hospital, Bandung, West Java. The consecutive sampling included all patients who fulfilled the following criteria: (1) aged 10-18 years, (2) diagnosed with CKD at least 3 months prior to the study, and (3) whose parents provided informed consent. The Strengths and Difficulties Questionnaire (SDQ) was used to assess emotional/behavioral disorders. Socio-demographic and clinical data were collected from medical records and interviews with parents. Chi-square and Mann-Whitney tests were used in the statistical analyses.
Results A total of 75 subjects with CKD participated in the study. The majority of the subjects were female (53%) and <14 years old (55%). Emotional/behavioral disorders were found in 24 subjects (32%). There were no significant correlations between age, gender, paternal and maternal education level, duration of illness, or treatment with emotional/behavioral problems. However, later stage of CKD was significantly associated with prosocial problems, based on the SDQ assessment.
Conclusion Late stage CKD is significantly associated with prosocial problems of the SDQ scales.
References
2. Sekarwana N, Pabuti A. Chronic kidney disease. In: Rachmadi D, Sekarwana N, Hilmanto D. Pediatric nephrology textbook. 3rd ed. Jakarta: Indonesian Pediatric Society; 2017. p. 609– 23.
3. Moreira JM, Bouissou Morais Soares CM, Teixeira AL Simões e Silva AC, Kummer AM. Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease. Pediatr Nephrol. 2015;30:2153–62.
4. Yeo M. Sawyer S. Chronic illness and disability. BMJ. 2005;330:721–3
5. Manti P, Giannakopoulos G, Giouroukou E, Georgaki-Angelaki HG, Stefanidis CJ, Mitsioni A, et al. Psychosocial and cognitive function in children with nephrotic syndrome: association with disease and treatment variables. Biopsychosoc Med. 2013;7:10.
6. Wolff G, Strecker K, Vester U, Latta K, Ehrich JH. Non-compliance following renal transplantation in children and adolescents. Pediatr Nephrol. 1998;12:703–8.
7. Marciano RC, Soares CM, Diniz JSS, Lima EM, Silva JM, Canhestro MR, et al. Behavioral disorders and low quality of life in children and adolescents with chronic kidney disease. Pediatr Nephrol. 2011;26:281–90.
8. Hoosen N, Davids EL, de Vries PJ, Shung-King M. The Strengths And Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validation. Child Adolesc Psychiatry Ment Health. 2018;12:1–39.
9. Oktaviana M, Wimbarti S. Validasi klinik strenghts and difficulties questionnaire (SDQ) sebagai instrumen skrining gangguan tingkah laku. Jurnal Psikologi. 2014;41:101–14.
10. Marciano RC, Soares CM, Diniz JS, Lima EM, Silva JM, Canhestro MR, et al. Mental disorders and quality of life in patients with chronic kidney disease. J Bras Nefrol. 2010;32:316–22.
11. Bakr A, Amr M, Sarhan A, Hammad A, Ragab M, El-Refaey A, et al. Psychiatric disorders in children with chronic renal failure. Pediatr Nephrol. 2007;22:128–31.
12. Holland-Hall C, Burstein G. Adolescent development. In: Kliegman RM, Stanton BF, St. Geme III JW, editors. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier; 2016. p. 926–31.
13. Soetjiningsih, Ranuh IG. Konsep dasar tumbuh kembang anak. In: editors? Tumbuh Kembang Anak. 2nd ed. Jakarta: Penerbit Buku Kedokteran EGC; 2014. p. 2-7.
14. Dhamayanti M. Masalah mental emosional pada remaja: deteksi dan intervensi. Sari Pediatri. 2011;13:45–51.
15. Fadrowski J, Cole SR, Hwang W, Fiorenza J, Weiss RA, Gerson A, et al. Changes in physical and psychosocial functioning among adolescents with chronic kidney disease. Pediatr Nephrol. 2006;21:394–9.
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Accepted 2019-12-16
Published 2019-12-16