Psychosocial symptoms in children of hemodialysis patients

Serious somatic illness in a parent represents a risk factor for psychosocial abnormalities in children. In a cross sectional study 24 families with a parent undergoing hemodialysis and at least one child living at home were examined. Patients, their spouses, children up from age 11 as well as the nephrologists in charge of the dialysis treatment were interrogated. In the parental perspective of a symptom checklist (CBCL), the children on average did not have higher scores for psychosocial abnormalities than a normative sample. In the self-reporting perspective (YSR), however, the adolescents averaged clinically abnormal scores. The discrepancy between the parental and the children's self-reporting scores were significant, which indicates an underestimation of children's psychological stress by both parents. Case analysis revealed a concentration of abnormalities within a quarter of the sample. This smaller subgroup showed clinically relevant scores in psychosocial abnormalities in the parental perspective, too. Younger children and children with additional life stressors had higher scores in psychosocial abnormalities. Futhermore, children's problems were correlated with depressive symptoms in one or both parents, which indicates an increased risk for children's psychological maladaptation in cases of depressive maladjustment to the illness in the ill parent or his spouse. It is concluded that children at special risk should be identified as early as possible. When problems are detected, counselling support should be offered to affected families.