title: Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a risk factor for psychosocial impairment and psychiatric symptoms. Children and adolescents on dialysis frequently have compromised daily life activities and a worse quality of life (QoL) compared with healthy peers. However, few studies have investigated these aspects of CKD in pediatric pre-dialysis CKD patients. Therefore, we have analyzed resilience, QoL and anxiety and depressive symptoms in children and adolescents with pre-dialysis CKD and compared these to the values of healthy controls.
  
  
  METHODS
  Demographic and clinical data were collected from 28 children and adolescents with pre-dialysis CKD and 28 healthy sex- and age-matched controls. Psychological assessment of the participants was performed using the Wagnild and Young Resilience Scale, Pediatric Quality of Life (QoL) Inventory 4.0 , Child Depression Inventory and Self-report for Childhood Anxiety Related Disorders scales.
  
  
  RESULTS
  Of the 56 children enrolled in our study, the CKD patients were referred to mental health professionals more frequently than the controls. Patients exhibited higher scores for separation anxiety and a higher frequency of clinically significant depressive symptoms. They also had lower overall QoL scores, as well as poorer scores for the psychological, educational and psychosocial subdomains of QoL instruments. There was a negative correlation between anxiety and depressive symptoms and all domains of QoL. Resilience was similar in both groups, but lower in patients with significant depressive symptoms. No significant association was found between clinical or laboratory findings and psychological variables in CKD patients.
  
  
  CONCLUSIONS
  Although patients and controls exhibited similar scores of resilience, CKD negatively impacted the QoL of pediatric patients, contributing to a higher frequency of depression and separation anxiety.
authors.affiliation: Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Federal University of Minas Gerais (UFMG), Avenida Alfredo Balena, 190, 2o andar, sala 281, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
authors.forename: Janaina Matos
authors.initials: JM
authors.lastname: Moreira
authors.affiliation: Pediatric Nephrology Unit, UFMG University Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Cristina Maria
authors.initials: CM
authors.lastname: Bouissou Morais Soares
authors.affiliation: Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Federal University of Minas Gerais (UFMG), Avenida Alfredo Balena, 190, 2o andar, sala 281, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
authors.forename: Antônio Lúcio
authors.initials: AL
authors.lastname: Teixeira
authors.affiliation: Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Federal University of Minas Gerais (UFMG), Avenida Alfredo Balena, 190, 2o andar, sala 281, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil. acssilva@hotmail.com.|Pediatric Nephrology Unit, UFMG University Hospital, Belo Horizonte, Minas Gerais, Brazil. acssilva@hotmail.com.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões E Silva
authors.affiliation: Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Federal University of Minas Gerais (UFMG), Avenida Alfredo Balena, 190, 2o andar, sala 281, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
authors.forename: Arthur Melo
authors.initials: AM
authors.lastname: Kummer
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000523:psychology*; D051436:Renal Insufficiency, Chronic / Q000523:psychology* / Q000628:therapy; D055500:Resilience, Psychological; D011795:Surveys and Questionnaires
keywords: Chronic kidney disease; Pediatric; Psychiatry; Quality of life; Resilience