title: Screening for depression in hospitalized pediatric patients.
abstract: OBJECTIVE
  In chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhood malignancies, the effect of treatment on child's psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad.
  
  
  METHODS
  After receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded. Three groups of children (children with chronic renal disease, malignancy, and acute disease) were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI). Two specifically trained nurses filled out the questionnaires at patients' bedside under the supervision of a psychiatrist. Depression scores were then analyzed by SPSS software.
  
  
  RESULTS
  Of 90 children, 43(47.7%) were male and 47(52.2%) were female. The Children's mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days. Depression was detected in various degrees in 63% of patients (N=57), and 36.6% of children (N=32) had no symptoms of depression. Severe depression was not seen in any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had moderate to severe depression. There was a significant statistical relationship between the duration of illness and severity of depression. There was also a significant correlation between severity of depression and frequency of hospitalization. Children who had been hospitalized more than 3 times in the previous year, experienced more severe levels of depression. We also found a significant correlation between pubertal age and severity of depression in patients with cancers and chronic renal failure.
  
  
  CONCLUSIONS
  Children who are hospitalized due to chronic conditions are at a higher risk for mood disorders in comparison with the ones with acute conditions. It is therefore advisable to consider more practical plans to improve the care for hospitalized children's mental health.
authors.affiliation: Pediatric Nephrology Department, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Esmaeeli
authors.affiliation: Anesthesiology Department, Pain Clinic, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Erfani Sayar
authors.affiliation: Psychiatry Department, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Saghebi
authors.affiliation: Pediatric Department, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Saghi
authors.initials: S
authors.lastname: Elmi
authors.affiliation: Research Center for Patient Safety and Health Quality, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Shagheyegh
authors.initials: S
authors.lastname: Rahmani
authors.affiliation: Research Center for Patient Safety and Health Quality, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Sam
authors.initials: S
authors.lastname: Elmi
authors.affiliation: MSc of Mental Health Nursing, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Akram
authors.initials: A
authors.lastname: Rabbani Javadi
keywords: Depression; Hospitalization; Pediatric patients