The role of parents and family support

Discrepancies between parents and children's assessments of depressive disorder symptoms are common. This can have important implications for the treatment and support of young patients. Parents often perceive their children as more depressed than the children describe themselves. Why is this the case?

First, the differences in assessment may be due to different perspectives. Parents and children may interpret the same behaviors and emotions differently, often resulting from differences in life experiences and ways of coping with stress. Parents are more sensitive to signs of distress and may interpret them as symptoms of depression. At the same time, children are more likely to have an optimistic view of reality, which can lead them to underestimate their emotional difficulties.

Parents' anxiety also plays an important role. Caring for a child with a chronic illness brings stress and uncertainty, which can affect perceptions of the child's mental health. Concern for the future and the burden of responsibility can cause parents to sometimes overestimate their children's depressive symptoms. On the other hand, children may downplay their symptoms to protect their parents from additional worries or to show strength and self-reliance.

The consequences of these discrepancies can be severe. First and foremost, they can lead to delayed interventions. If parents' concerns are not taken seriously enough, psychological support can come too late, and early diagnosis is crucial for effective treatment. In addition, differences in assessment can cause tension in family relationships. Lack of agreement about a child's mental health can hinder open communication and cooperation, which is essential for coping with the disease.

This complexity of assessing the emotional state of children with chronic illnesses demonstrates the importance of a personalized approach that takes into account both the perspective of the child and their parents. Experts stress that an approach that takes into account the assessments of both parties can provide information about the child's risk factors and resilience to depression. Early recognition of emotional problems, especially in children diagnosed at a young age or in those whose illness is rapidly progressing, is fundamental. Early intervention not only reduces the risk of developing depression but also limits its impact on patients' daily lives.

"We take a holistic approach to the patient, talking to the patient and family members during hospital visits. It is essential to inspire trust in the patient and his family and get them to cooperate" says Prof. Katarzyna Kiliś-Pstrusińska. "We know, among other things from our research, what the manifestations of depressive disorders can be and what factors predispose to them, which sharpens our focus. The observations of experienced nursing staff are also helpful" she adds.

An interdisciplinary approach involving the collaboration of nephrologists, psychologists, and family therapists is considered most effective in holistically supporting patients. The key here is to build trust and create a space for frank conversations with the child's family.

"We talk to parents and ask them how they perceive their child, not just somatically. Whenever we have doubts or suspect the presence of a disorder, we ask for a consultation with a psychologist and psychiatrist" stresses Prof. Kiliś-Pstrusińska

Creating effective psychological support protocols as early as the stage of CKD diagnosis can play a key role in improving children's adaptation to life with the disease. Such measures can increase the effectiveness of treatment and help young patients and their families better adjust to their new reality.