Division of Pediatric Nephrology, Cohen Children's Medical Center, 420 Lakeville Road, New Hyde Park, NY, 11364, USA.
Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA.
Pediatr Nephrol. 2024 Oct;39(10):2887-2897. doi: 10.1007/s00467-024-06314-8. Epub 2024 Mar 8.
The mental health of youth with chronic kidney disease (CKD) has been increasingly recognized as an area of clinical need. The development of mental health concerns is influenced by a range of physiological, psychological, and environmental factors. Some of these factors are common across child development, but some are more unique to youth with CKD. Mental health concerns are associated with increased risk for a range of poor medical outcomes (e.g., adherence, risk of transplant rejection) and quality of life concerns. In this educational review, we discuss the current evidence base regarding the development of mental health concerns in youth with CKD. The review covers multiple domains including mood and anxiety disorders, traumatic stress, and neurodevelopmental disorders. Estimated prevalence and hypothesized risk factors are outlined, and the potential impact of mental health on medical care and functional outcomes are reviewed. Finally, we introduce options for intervention to support positive mental health and offer recommendations for building access to mental health care and improving the mental health education/training of medical professionals.
青少年慢性肾脏病（CKD）患者的心理健康越来越受到重视，这是临床需求的一个领域。心理健康问题的发展受到一系列生理、心理和环境因素的影响。其中一些因素在儿童发育过程中普遍存在，但也有一些因素在 CKD 青少年中更为独特。心理健康问题与一系列不良医疗结局（如依从性、移植排斥风险）和生活质量问题的风险增加有关。在本次教育综述中，我们讨论了青少年 CKD 患者心理健康问题发展的现有证据基础。综述涵盖了多个领域，包括情绪和焦虑障碍、创伤后应激障碍和神经发育障碍。概述了估计的患病率和假设的危险因素，并回顾了心理健康对医疗护理和功能结局的潜在影响。最后，我们介绍了支持心理健康的干预措施，并为改善精神卫生保健的可及性和提高医疗专业人员的精神卫生教育/培训提出了建议。
