The mental health profiles of pediatric organ transplant recipients

Pediatr Transplant. 2022 Feb;26(1):e14151. doi: 10.1111/petr.14151. Epub 2021 Oct 9.

Abstract

Background: Solid organ transplantation is the indicated treatment for children with end-stage organ failure. Little is known about the impact of organ transplantation on pediatric transplant recipients' mental health. Symptoms of medical procedure and generalized anxiety, post-traumatic stress, and depression may emerge, despite the successful restoration of organ function.

Methods: We examined symptoms of anxiety, depression, trauma, and medical procedure anxiety-specifically, fear and avoidance of needles-in youth who had received a kidney, liver, or heart transplant. Parent-report on child mental health symptoms was also collected.

Results: Data were obtained for 56 youth. Most children did not endorse clinically significant symptoms of depression. In contrast, 20% of parents reported symptoms of depression in their child that exceeded clinical cutoffs. Parents also reported higher levels of anxiety in their children than did the children themselves. Indeed, on average, children reported lower levels of depression and anxiety than would be expected in a general population. On a trauma measure, 22.6% of youths' scores were above clinical cutoffs, with girls scoring higher than boys. Finally, 10.9% of children stated that they attempted to avoid needles because of fear. Once again, girls reported higher needle fear scores than boys and younger patients reported experiencing higher levels of needle fear.

Conclusions: Anxiety, depression, post-traumatic stress, and needle fear are important psychological parameters that should be considered in the evaluation of pediatric patients with solid organ transplant, as part of their routine post-transplant care.

Keywords: anxiety; depression; mental health; needle phobia; pediatric transplant; post-traumatic stress; procedural anxiety; psychosocial functioning; solid organ transplant; trauma.

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Child
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / etiology*
  • Female
  • Humans
  • Male
  • Organ Transplantation / psychology*
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / psychology
  • Psychological Tests
  • Retrospective Studies
  • Self Report
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology*
  • Transplant Recipients / psychology*
  • Young Adult