Teen kidney recipients at greater risk for mental health issues

Depression, attention deficit hyperactivity disorder and phobias are more common among pediatric kidney transplant patients than among healthy young persons, according to online research in Pediatric Transplantation.

Results showed that 65% of children with transplants were diagnosed with at least one lifetime psychiatric disorder, compared with 37.5% of controls. Adolescent patients with transplants were also more likely to be educationally and socially impaired.

This controlled trial evaluated 100 adolescent patients aged 12 to 18 from two Montreal medical centers. Of the patients, 40 had transplants, 20 had chronic kidney disease and 40 were healthy controls. Interviews and questionnaires tracked psychiatric symptoms and disorders.

Researchers found that the transplant group showed a markedly higher lifetime incidence of DSM-IV diagnoses (65% were diagnosed with one or more lifetime psychiatric disorders, compared with 37.5% of controls). There was a 35% lifetime depressive disorder rate in the transplant and chronic kidney disease group (only 15.2% in the control group).

Results also indicated nearly twice the rate of anxiety disorders, as well as notably more mood and behavioral disorders than the controls. Additionally, those boys who had received a transplant saw a high rate of ADHD (31%), compared with 7.5% of controls. Issues with learning affected 30% of transplanted patients and 15% of those with chronic kidney disease, while only affecting 7.5% of controls.

In conclusion, researchers, led by Eric Fombonne, MD, state that results "underscore the need for continuous multidisciplinary collaboration in the care of these patients. Because transplant patients face a lifelong disease and may remain at risk for developing psychiatric disorders, special attention should be paid when transferring their care from pediatric to adult services."

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