Department of Psychology, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Pediatr Transplant. 2022 Feb;26(1):e14151. doi: 10.1111/petr.14151. Epub 2021 Oct 9.
Solid organ transplantation is the indicated treatment for children with end-stage organ failure. Little is known about the impact of organ transplantation on pediatric transplant recipients' mental health. Symptoms of medical procedure and generalized anxiety, post-traumatic stress, and depression may emerge, despite the successful restoration of organ function.
We examined symptoms of anxiety, depression, trauma, and medical procedure anxiety-specifically, fear and avoidance of needles-in youth who had received a kidney, liver, or heart transplant. Parent-report on child mental health symptoms was also collected.
Data were obtained for 56 youth. Most children did not endorse clinically significant symptoms of depression. In contrast, 20% of parents reported symptoms of depression in their child that exceeded clinical cutoffs. Parents also reported higher levels of anxiety in their children than did the children themselves. Indeed, on average, children reported lower levels of depression and anxiety than would be expected in a general population. On a trauma measure, 22.6% of youths' scores were above clinical cutoffs, with girls scoring higher than boys. Finally, 10.9% of children stated that they attempted to avoid needles because of fear. Once again, girls reported higher needle fear scores than boys and younger patients reported experiencing higher levels of needle fear.
Anxiety, depression, post-traumatic stress, and needle fear are important psychological parameters that should be considered in the evaluation of pediatric patients with solid organ transplant, as part of their routine post-transplant care.
实体器官移植是治疗儿童终末期器官衰竭的首选方法。尽管器官功能成功恢复,但对于器官移植对儿科受者心理健康的影响知之甚少。尽管器官功能成功恢复,但仍可能出现与医疗程序相关的焦虑、广泛性焦虑、创伤后应激和抑郁症状。
我们检查了接受肾、肝或心脏移植的儿童的焦虑、抑郁、创伤和医疗程序焦虑(具体为对针的恐惧和回避)的症状。还收集了父母对儿童心理健康症状的报告。
获得了 56 名青少年的数据。大多数儿童没有表现出明显的抑郁症状。相比之下,20%的父母报告其子女的抑郁症状超过临床标准。父母还报告说,他们的孩子比孩子自己更焦虑。事实上,平均而言,儿童报告的抑郁和焦虑水平低于一般人群。在创伤量表上,22.6%的青少年得分高于临床标准,女孩的得分高于男孩。最后,10.9%的儿童表示他们因恐惧而试图避免打针。同样,女孩的针恐惧评分高于男孩,年轻患者的针恐惧水平更高。
焦虑、抑郁、创伤后应激和针恐惧是重要的心理参数,应作为儿童实体器官移植患者常规移植后护理的一部分,在评估中加以考虑。