SAGE-Hindawi Access to Research International Journal of Nephrology Volume 2011, Article ID 798692, 7 pages doi:10.4061/2011/798692 Research Article Depressive Symptomatology in Children and Adolescents with Chronic Renal Insufﬁciency Undergoing Chronic Dialysis Edith G. Hernandez,1 Reyner Loza,1 Horacio Vargas,2 and Mercedes F. Jara1 1 Pediatric Nephrology Unit, Cayetano Heredia National Hospital, San Mart´ın de Porras, Lima, Lima 31, Peru 2 Pediatric Psychiatric Unit, The National Institute of Mental Health “Honorio Delgado-Hideyo Noguchi”, Lima, Lima 31, Peru Correspondence should be addressed to Reyner Loza, reyfe@hotmail.com Received 14 February 2011; Accepted 19 July 2011 Academic Editor: Patrick Niaudet Copyright © 2011 Edith G. Hernandez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This paper presents a descriptive study, using the Birleson Scale to determine the frequency of depressive symptomatology in children and adolescents with chronic renal insuﬃciency (CRI) undergoing hemodialysis (HD) and chronic peritoneal dialysis (CPD). There were 67 patients (40 female and 27 male) with a mean age of 14.76 ± 2.71 years, duration of illness ≥3 months, 43 (64.18%) patients with CPD and 24 (35.82%) undergoing HD. The frequency of high occurrence, low occurrence, and absence of depressive symptomatology was 10.45% (n = 7), 43.28% (n = 29), and 46.27% (n = 31), respectively; all of the seven (100%) patients with high occurrence of depressive symptomatology were female (P = 0.04), and none of these (0%) had a friend to conﬁde in (P = 0.03). Depressive symptomatology in patients with CPD was associated with a lower weekly Kt/V compared to those without depressive symptomatology (2.15 ± 0.68 versus 2.52 ± 0.65; P = 0.01). There was no association with patient age, caregiver, time and dialysis type, anemia, bone disease, nutritional or ﬁnancial status, origin, schooling, or employment. 1. Introduction Depression is a public mental health problem that aﬀects children, adolescents, and adults, negatively impacting their personal, academic, social, and family lives [1]. In recent years the prevalence of depression has increased worldwide, and, at the same time, the presentation age has decreased. According to the World Health Organization (WHO), this makes it the medical condition with the fourth highest loss of life years due to premature death or years living with a severe and chronic incapacity [1]. The deﬁnition of depression is a mood alteration charac- terized by a depressed state of mind, decreased enjoyment and concentration, lack of interest, a feeling of disability, guilt, and hopelessness, insomnia, reduced appetite, and su- icide ideation. The earlier it is present, the greater the risk of suicide, substance abuse, and behavioral problems; for this reason it is very important to diagnose and treat quickly [2]. The prevalence of depression is about 3–5% in children and around 8% in adolescents, with a female predominance [3, 4]. The presence of depressive symptoms is about 15%. These frequencies increase in patients with a chronic disease [5]. Depression is the most common mental alteration in patients with terminal chronic renal insuﬃciency, which is neither diagnosed nor studied [5]. Livesley found that the frequency of anxiety, personality disorder, and depression in patients with chronic dialysis was signiﬁcantly higher than in healthy individuals [6]. Lopes and colleagues found a 20% prevalence of depression in 5256 patients and 13.9% in 9382 patients, both undergoing chronic hemodialysis [7, 8]. Bakr and coworkers compared children undergoing chronic hemodialysis with children not undergoing chronic hemodialysis, ﬁnding that 52.6% of the hemodialysis patients had psychiatric alterations, and of these 10.3% had depres- sion. The prevalence of depression changes according to the studied population and the diagnostic method [9, 10]. Diﬀerent studies show an association between depres- sion, decrease in length of life, and adherence to therapy, with an increase of 15 times the suicide risk and an increasing number of hospitalizations. This makes it an independent risk factor predicting mortality, and one with a signiﬁcant