ORIGINAL ARTICLE Psychiatric disorders in children with chronic renal failure Ashraf Bakr & Mostafa Amr & Amr Sarhan & Ayman Hammad & Mohamed Ragab & Ahmed El-Refaey & Atef El-Mougy Received: 5 July 2006 / Revised: 7 August 2006 / Accepted: 9 August 2006 / Published online: 19 September 2006 # IPNA 2006 Abstract Psychiatric assessment was done according to the DSM-IV TR criteria in 19 children with predialysis chronic renal failure (CRF) and 19 children with end- stage renal disease on regular hemodialysis. The preva- lence rate of psychiatric disorders in all the studied patients was 52.6%. Adjustment disorders were the most common disorders (18.4%), followed by depression (10.3%) and neurocognitive disorders (7.7%). Anxiety and elimination disorders were reported in 5.1 and 2.6%, respectively. The disorders were more prevalent (P=0.05) in dialysis (68.4%) than in predialysis patients (36.8%). The presence of psychiatric disorders was not signifi- cantly correlated with sex, severity of anemia, duration of CRF or the efficiency or the duration of hemodialysis. In conclusion, psychiatric disorders were prevalent in our patients, especially in those on hemodialysis. Both adjustments with depression and depressive disorders were the most common psychiatric disorders. This array of disorders was more likely explained by the difficulties encountered in living with CRF rather than by demo- graphic or physical factors. Keywords Chronic renal failure . Children . Psychiatric disorders Introduction Consultation-liaison psychiatry in renal medicine provides a unique experience for the psychiatrist as it provides the opportunity to work with a specialist multi-disciplinary team managing patients with chronic and complex physical problems in in-patient and out-patient settings [1]. Psychiatric morbidity is defined as the presence of handicapping abnormalities of emotions, behavior, and relationships that impede personal and social functioning [2]. The presence of psychiatric morbidity can be objec- tively measured by the use of questionnaires and interviews. The best are those with established psycho- metric properties that show satisfactory reliability and validity data for the population under study [2]. The semi-structured clinical interview for children and adoles- cents (SCICA) is an example of interviews that depends quantitatively on structured observation and self-report forms [3]. Advances in medical care, including improvements in dialysis and transplantation, have increased the survival rates for children with chronic renal failure (CRF). This long survival increases the opportunities for the develop- ment of psychiatric morbidity among these children [4]. The prevalence as well as the pattern of psychiatric disorders among children with CRF vary from one study to another [4–7]. This liaison-psychiatric study aimed to uncover the common psychiatric disorders among Egyptian children with CRF in a pediatric nephrology unit at Mansoura University Children_s Hospital by using SCICA. DSM-IV- TR criteria were used to make psychiatric diagnoses [8]. Pediatr Nephrol (2007) 22:128–131 DOI 10.1007/s00467-006-0298-9 A. Bakr (*) : A. Sarhan : A. Hammad : M. Ragab : A. El-Refaey : A. El-Mougy Nephrology unit, Mansoura University Children_s Hospital, Mansoura, Egypt e-mail: ashbakr@mans.edu.eg M. Amr Psychiatry unit, Mansoura University Children_s Hospital, Mansoura, Egypt