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Mental health and psychosocial adjustment in pediatric chronic kidney disease derived from the KNOW-Ped CKD study

 Na Ri Kang  ;  Yo Han Ahn  ;  Eujin Park  ;  Hyun Jin Choi  ;  Seong Heon Kim  ;  Heeyeon Cho  ;  Min Hyun Cho  ;  Jae Il Shin  ;  Joo Hoon Lee  ;  Young Seo Park  ;  Hae Il Cheong  ;  Hee Gyung Kang  ;  Il-Soo Ha  ;  Young Sook Kwack  ;  Kyoung Hee Han 
 PEDIATRIC NEPHROLOGY, Vol.34(10) : 1753-1764, 2019 
Journal Title
Issue Date
Children ; Chronic kidney disease ; Mental health ; Psychosocial adjustment
BACKGROUND: Psychosocial development of pediatric chronic kidney disease (CKD) patients is substantially affected due to growth retardation, frequent school absences, and difficulties engaging in normal peer relationship activities. While many studies focus on specific issues such as depression, anxiety, or neurocognitive function, few evaluate prevalence of various types of mental health and psychosocial adjustment problems among children with CKD. This study aimed to investigate these within the KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease (KNOW-Ped CKD).

METHODS: One hundred sixty-six subjects who completed the Korean-Child Behavioral Checklist (K-CBCL) were included. The clinical group comprised subjects with scores indicating psychosocial adjustment or mental health problems using the T scores for the 14 subscales of the K-CBCL. We analyzed associations between mental health or adjustment problems in pediatric CKD and each variable.

RESULTS: Mean age was 11.1 (± 3.9) years, number of males was 117 (70.5%), and 20.5% and 22.3% of children had significant mental health problems and psychosocial adjustment problems, respectively. Overall, 33.1% were assigned to the clinical group, and exhibited short stature and higher rates of preterm birth history compared to the non-clinical group. Subjects with adjustment problems had higher comorbidities such as CNS disease, developmental delay, cardiovascular disease, and multi-organ involvement. Logistic regression analysis revealed preterm birth and developmental delay correlated highly with clinical group.

CONCLUSIONS: A significant proportion of children and adolescents with CKD experience mental health and adjustment problems. In particular, patients with developmental delay or preterm birth history require screening and targeted follow-up.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
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