Abstract

Objective: Pediatric patients undergoing transplantation are at increased risk for a variety of psychiatric problems. The aim of this study was to analyse the  data of children and adolescents referred to the child and adolescent psychiatry unit of a tertiary hospital and who were in the process of transplantation.

Material and Methods: This retrospective observational study, planned using the hospital information system and patient records, included clinical data over a 6-year period. Patients were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Results: This study included the data of 64 patients (n= 30, 46.9% girls) in the transplantation process. Of the patients, 46 (71.9%) were undergoing kidney transplantation, 13 (20.3%) bone marrow transplantation, two (3.1%) liver transplantation, two (3.1%) lung transplantation, and one (1.6%) heart transplantation. The duration of pre-transplant illness was approximately 5.21±4.17 years. The most common reason for admission to child psychiatry unit was pre-transplant psychiatric and intelligence assessment. Thirty-two (50%) patients were diagnosed with any mental illness. The most common diagnoses were depression and adjustment disorder. No association was found between the duration of pre-transplant illness and the mean psychiatric diagnosis (r= -0.101, p= 0.603).

Conclusion: The data from this study will help to guide mental health and psychosocial care in this population. Prospective longitudinal studies of children are needed to determine optimal psychiatric assessment.

Keywords: Adjustment disorder, bone marrow transplant, children, depressive disorder, kidney transplant

References

  1. Amatya K, Monnin K, Steinberg Christofferson E. Psychological functioning and psychosocial issues in pediatric kidney transplant recipients. Pediatr Transplant 2021;25(1):e13842. https://doi.org/10.1111/petr.13842
  2. Costa-Requena G, Cantarell M, Moreso FJ, Parramon G, Seron D. Health-related behaviours after 1 year of renal transplantation. J Health Psychol 2017;22(4):505-14. https://doi.org/10.1177/1359105315604889
  3. Dobbels F, Decorte A, Roskams A, Van Damme-Lombaerts R. Health-related quality of life, treatment adherence, symptom experience and depression in adolescent renal transplant patients. Pediatr Transplant 2010;14(2):216-23. https://doi.org/10.1111/j.1399-3046.2009.01197.x
  4. Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, et al. Symptom burden and health-related quality of life in chronic kidney ilnes: A global systematic review and meta-analysis. PLoS Med 2022;19(4):e1003954. https://doi.org/10.1371/journal.pmed.1003954
  5. Golenia A, Olejnik P, Żołek N, Wojtaszek E, Małyszko J. Cognitive Impairment and Anxiety Are Prevalent in Kidney Transplant Recipients. Kidney Blood Press Res 2023;48(1):587-95. https://doi.org/10.1159/000533755
  6. Penner EK, Walker H, Moon E, Slavec J, Hind T, Blydt-Hansen TD. The mental health profiles of pediatric organ transplant recipients. Pediatr Transplant 2022;26(1):e14151. https://doi.org/10.1111/petr.14151
  7. Abrão RO, Lopes M, Silva GJS, Ferraro AA, Koch VH. Study of the association between generic and disease-specific quality of life and behavior problems in pediatric patients with chronic kidney disease stage 3 or higher and the quality of life and mental health of their primary caregivers. Pediatr Nephrol 2021;36(10):3201-10. https://doi.org/10.1007/s00467-021-04986-0
  8. Li JL, Ye Q, Liu N. Cancer parents’ experiences of parenting concerns about minor children: A meta-synthesis of qualitative studies. Int J Nurs Stud Adv 2024;6:100210. https://doi.org/10.1016/j.ijnsa.2024.100210
  9. Cupit MC, Duncan C, Savani BN, Hashmi SK. Childhood to adult transition and long-term follow-up after blood and marrow transplantation. Bone Marrow Transplant. 2016;51(2):176-81.https://doi.org/10.1038/bmt.2015.228
  10. Chen A, Farney A, Russell GB, Nicolotti L, Stratta R, Rogers J, et al. Severe intellectual disability is not a contraindication to kidney transplantation in children. Pediatr Transplant 2017;21(3). https://doi.org/10.1111/petr.12887
  11. Wightman A, Hsu E, Zhao Q, Smith J. Prevalence and Outcomes of Liver Transplantation in Children With Intellectual Disability. J Pediatr Gastroenterol Nutr 2016;62(6):808-12.https://doi.org/10.1097/MPG.0000000000001071
  12. Willem L, Knops N, Mekahli D, Cochat P, Edefonti A, et al. Renal Replacement Therapy in children with severe developmental disability: guiding questions for decision-making. Eur J Pediatr 2018;177(12):1735-43. https://doi.org/10.1007/s00431-018-3238-3
  13. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36(7):980-8. https://doi.org/10.1097/00004583-199707000-00021
  14. Gokler B. Reliability and validity of schedule for affective disorders and Schizophrenia for school age children-present and lifetime version-Turkish version (K-SADS-PL-T). Turk J Child Adolesc Mental Health 2004; 11: 109-16 [in Turkish].
  15. Duvant P, Fillat M, Garaix F, Roquelaure B, Ovaert C, Fouilloux V, Tsimaratos M, Auquier P, Fabre A, Baumstarck K. Quality of life of transplanted children and their parents: a cross-sectional study. Orphanet J Rare Dis 2021;16(1):364. https://doi.org/10.1186/s13023-021-01987-y
  16. Kang NR, Ahn YH, Park E, Choi HJ, Kim SH, et al. Mental health and psychosocial adjustment in pediatric chronic kidney disease derived from the KNOW-Ped CKD study. Pediatr Nephrol 2019;34(10):1753-64. https://doi.org/10.1007/s00467-019-04292-w
  17. Uçgun T, Akgün Çıtak E. Unveiling the Psychosocial Impact: Pediatric Organ Transplantation and Posttraumatic Stress Disorders: A Systematic Review. Exp Clin Transplant 2024; 22(Suppl 5):41-8.
  18. Akın Sarı B, Baskın SE, Özçay F, Sezgin A, Haberal M. Psychiatric Evaluation of Children During the Organ Transplant Process. Exp Clin Transplant 2018 Apr 9. Advance online publication. https://doi.org/10.6002/ect.2017.0056.
  19. Sher Y, Zimbrean P. Psychiatric Aspects of Organ Transplantation in Critical Care: An Update. Crit Care Clin 2017;33(3):659-79. https://doi.org/10.1016/j.ccc.2017.03.009
  20. Inoue K, Kawanishi C, Otsuka K, Cho Y, Shiraishi M, et al. A large-scale survey of inpatient suicides: comparison between medical and psychiatric settings. Psychiatr Res 2017;250:155-8.https://doi.org/10.1016/j.psychres.2017.01.076
  21. Foster BJ, Pai ALH, Zelikovsky N, Amaral S, Bell L, et al. A Randomized Trial of a Multicomponent Intervention to Promote Medication Adherence: The Teen Adherence in Kidney Transplant Effectiveness of Intervention Trial (TAKE-IT). Am J Kidney Dis 2018;72(1):30-41. https://doi.org/10.1053/j.ajkd.2017.12.012
  22. Law E, Fisher E, Eccleston C, Palermo TM. Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev 2019;3(3):CD009660. https://doi.org/10.1002/14651858.CD009660.pub4
  23. Purdy J. Chronic physical illness: a psychophysiological approach for chronic physical illness. Yale J Biol Med 2013;86(1):15-28.
  24. Lin J, Chadi N, Shrier L. Mindfulness-based interventions for adolescent health. Curr Opin Pediatr. 2019;31(4):469-75. https://doi.org/10.1097/MOP.0000000000000760
  25. Medved V, Medved S, Skočić Hanžek M. Transplantation psychiatry: an overview. Psychiatr Danubina 2019; 31(1):18-25. https://doi.org/10.24869/psyd.2019.18

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Copyright © 2025 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Ünver H, Bırık HE, Perdahlı Fiş N. Psychiatric aspects of children in the transplantation process: 6-year outcomes from a tertiary hospital. Turk J Pediatr Dis [Internet]. 2025 Aug. 4 [cited 2025 Aug. 23];:1-6. Available from: https://turkjpediatrdis.org/article/view/1164