Emotional and behavioral problems after pediatric liver transplantation: a quantitative assessment.
Several uncertainties regarding psychological problems in children who underwent liver transplantation and the need to differentiate these disturbances from those related to the underlying previous chronic liver disease itself exist. This background triggered the present pilot study to investigate, using quantitative assessment methods, the incidence and the type of emotional and behavioral disturbances after liver transplantation. Sixteen liver transplant recipients (aged 5.7-14.4 yr) and 12 age-matched controls with stable chronic liver disease were assessed through the parent report form of Child Behavior Checklist/ 4-18. The mean time elapsed since transplantation was 8.1 yr. No patient or family had received psychological support during chronic liver disease or at any phase of the transplantation process. Transplanted children scored within borderline range for Internalizing and Total Behavioral Problems and within pathological range for Competences, except for the Activity Scale. Transplanted children showed more Total Behavioral (p = 0.005) and Externalizing Problems (p = 0.0005) than controls. Both groups scored within the pathological range for Total Competences with no significant differences between the two groups. Our findings suggest that in the absence of support programs a psychological risk does exist for a long period of time, after transplantation. Regarding Total Behavioral Problems and Externalizing Problems, this risk is higher than in children with chronic liver disease.
Department of Psychiatry, Child Neuropsychiatry, Audiophonology and Dermatology, Second University of Naples, Naples, Italy. antonella.gritti@unina2.it
Antonella
A
Gritti
Federico
F
Sicca
Angela Maria
AM
Di Sarno
Nicolina
N
Di Cosmo
Serena
S
Vajro
Pietro
P
Vajro
D000293:Adolescent; D000342:Affective Symptoms / Q000209:etiology*; D001656:Biliary Atresia / Q000601:surgery; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007389:Internal-External Control; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D010865:Pilot Projects; D011184:Postoperative Period