Multi-method assessment of behavior adjustment in children with chronic kidney disease

To describe the psychological adjustment in children with chronic kidney disease (CKD), we studied behavioral problems in 19 patients with CKD stage 5 on regular hemodialysis, 19 patients in the predialysis stage, and 19 control children, using the child behavior checklist (CBCL) and the semi-structured clinical interview for children and adolescents (SCICA). For CBCL scales, the mean score on the internalizing scale was significantly higher in the children on dialysis than in predialysis and control children. No significant differences in the mean scores of the total problem or externalizing scales were found between the groups studied. The mean score of SCICA observed problems and total self-reports were significantly higher in the control group than in the CKD groups. The mean score on total self-report was significantly higher in the control children than in the predialysis group. There were significant positive correlations between SCICA self-report and all CBCL scales. No significant correlations were found between these CBCL and SCICA scales and age, gender, severity of anemia, duration of CKD or the efficiency or the duration of hemodialysis in the CKD patients. In conclusion, multi-method assessment of children’s adjustment through different informants yields a comprehensive view of child psychopathology in CKD that calls for psychosocial support and early identification of maladjustment.