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Mai K, Dawson AE, Gu L, LaMotte JE, Molitor S, Zimmerman CT. Common mental health conditions and considerations in pediatric chronic kidney disease. Pediatr Nephrol 2024; 39:2887-2897. [PMID: 38456918 DOI: 10.1007/s00467-024-06314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 03/09/2024]
Abstract
The mental health of youth with chronic kidney disease (CKD) has been increasingly recognized as an area of clinical need. The development of mental health concerns is influenced by a range of physiological, psychological, and environmental factors. Some of these factors are common across child development, but some are more unique to youth with CKD. Mental health concerns are associated with increased risk for a range of poor medical outcomes (e.g., adherence, risk of transplant rejection) and quality of life concerns. In this educational review, we discuss the current evidence base regarding the development of mental health concerns in youth with CKD. The review covers multiple domains including mood and anxiety disorders, traumatic stress, and neurodevelopmental disorders. Estimated prevalence and hypothesized risk factors are outlined, and the potential impact of mental health on medical care and functional outcomes are reviewed. Finally, we introduce options for intervention to support positive mental health and offer recommendations for building access to mental health care and improving the mental health education/training of medical professionals.
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Affiliation(s)
- Katherine Mai
- Division of Pediatric Nephrology, Cohen Children's Medical Center, 420 Lakeville Road, New Hyde Park, NY, 11364, USA.
| | - Anne E Dawson
- Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA
- The Kidney and Urinary Tract Center, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lidan Gu
- Division of Clinical Behavioral Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - Julia E LaMotte
- Division of Child and Adolescent Psychiatry, Riley Children's Health, Indianapolis, IN, USA
| | - Stephen Molitor
- Division of Pediatric Psychology and Developmental Medicine, Department of Pediatrics, Medical College of Wisconsin Milwaukee, Milwaukee, WI, USA
| | - Cortney T Zimmerman
- Division of Psychology and Nephrology Service, Department of Pediatrics, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, 77030, USA
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Curie A, Touil N, Gaillard S, Galanaud D, Leboucq N, Deschênes G, Morin D, Abad F, Luauté J, Bodenan E, Roche L, Acquaviva C, Vianey-Saban C, Cochat P, Cotton F, Bertholet-Thomas A. Neuropsychological and neuroanatomical phenotype in 17 patients with cystinosis. Orphanet J Rare Dis 2020; 15:59. [PMID: 32102670 PMCID: PMC7045592 DOI: 10.1186/s13023-019-1271-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 12/03/2019] [Indexed: 01/19/2023] Open
Abstract
Background Cystinosis is a rare autosomal recessive disorder caused by intracellular cystine accumulation. Proximal tubulopathy (Fanconi syndrome) is one of the first signs, leading to end-stage renal disease between the age of 12 and 16. Other symptoms occur later and encompass endocrinopathies, distal myopathy and deterioration of the central nervous system. Treatment with cysteamine if started early can delay the progression of the disease. Little is known about the neurological impairment which occurs later. The goal of the present study was to find a possible neuroanatomical dysmorphic pattern that could help to explain the cognitive profile of cystinosis patients. We also performed a detailed review of the literature on neurocognitive complications associated with cystinosis. Methods 17 patients (mean age = 17.6 years, [5.4–33.3]) with cystinosis were included in the study. Neuropsychological assessment was performed including intelligence (Intelligence Quotient (IQ) with Wechsler’s scale), memory (Children Memory Scale and Wechsler Memory Scale), visuo-spatial (Rey’s figure test) and visuo-perceptual skills assessments. Structural brain MRI (3 T) was also performed in 16 out of 17 patients, with high resolution 3D T1-weighted, 3D FLAIR and spectroscopy sequences. Results Intellectual efficiency was normal in patients with cystinosis (mean Total IQ = 93). However the Perceptual Reasoning Index (mean = 87, [63–109]) was significantly lower than the Verbal Comprehension Index (mean = 100, [59–138], p = 0.003). Memory assessment showed no difference between visual and verbal memory. But the working memory was significantly impaired in comparison with the general memory skills (p = 0.003). Visuospatial skills assessment revealed copy and reproduction scores below the 50th percentile rank in more than 70% of the patients. Brain MRI showed cortical and sub-cortical cerebral atrophy, especially in the parieto-occipital region and FLAIR hypersignals in parietal, occipital and brain stem/cerebellum. Patients with atrophic brain had lower Total IQ scores compared to non-atrophic cystinosis patients. Conclusions Patients with cystinosis have a specific neuropsychological and neuroanatomical profile. We suggest performing a systematic neuropsychological assessment in such children aiming at considering adequate management.
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Affiliation(s)
- Aurore Curie
- Service de neuropédiatrie Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5304, 67 boulevard Pinel, 69675, Bron, France. .,Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5304, L2C2, Bron, France. .,Faculté de médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France. .,EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France.
| | - Nathalie Touil
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Ségolène Gaillard
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Damien Galanaud
- Service de neuroradiologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Nicolas Leboucq
- Service de neuroradiologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Georges Deschênes
- Service de néphropédiatrie, Hôpital Robert-Debré, AP-HP, Paris, France
| | - Denis Morin
- Service de néphrologie et diabétologie pédiatrique, Service de pédiatrie I, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Fanny Abad
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Jacques Luauté
- Service de rééducation fonctionnelle, Hôpital neurologique, Hospices Civils de Lyon, Bron, France
| | - Eurielle Bodenan
- EPICIME-CIC 1407/Inserm, UMR5558, Université de Lyon, Hospices Civils de Lyon, Bron, France
| | - Laurent Roche
- Service de biostatistiques, Hospices Civils de Lyon, Bron, France
| | - Cécile Acquaviva
- Service maladies héréditaires du métabolisme et dépistage néonatal, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est (GHE), Hospices Civils de Lyon, Bron, France
| | - Christine Vianey-Saban
- Service maladies héréditaires du métabolisme et dépistage néonatal, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est (GHE), Hospices Civils de Lyon, Bron, France
| | - Pierre Cochat
- Faculté de médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France.,Centre de référence des maladies rénales rares - Néphrogones - Filière ORKiD, Bron, France
| | - François Cotton
- Faculté de médecine Lyon Est, Université Claude-Bernard Lyon 1, Lyon, France.,Service de radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France.,CREATIS, CNRS UMR5220, INSERM U1044, Université Lyon 1, INSA Lyon, Villeurbanne, France
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