Young patients' depression a challenge for doctors

Psychologists at hospitals work with schools to screen children for potential problems, as Zhou Wenting reports.

When psychologists recently assessed a 10-year-old Shanghai girl who was diagnosed with an autoimmune disorder two years ago, they found the former top student was troubled by long-term, severe depression.

"I had high expectations for my studies and life, and so did my parents," the girl said. "But the disease trapped me in fear and despair, which I hid from my parents after I found they wouldn't allow me to be weak or give up."

Such cases are not rare among children with chronic diseases, according to doctors. These patients are more prone to negative emotions and mental health issues - such as anxiety, nervousness and irritability - owing to long medical treatment, disease relapses and the economic burden on their families.

"That's why we often find the expression in these young patients' eyes is different from their peers, and they are usually more thoughtful and mature," said Dong Jingcheng, director of Fudan University's Research Institute of Traditional Chinese Medicine Integrated with Western Medicine.

"We found in a study last year that even among adults, the incidence rate of psychological problems accompanying a tumor is as high as 40 percent."

Psychological support from families, hospitals and society as a whole needs to be provided to such children to help them recover and integrate in school and society, experts said.

A survey by Fudan University Children's Hospital in Shanghai found a third of the 52 children age 8 to 17 who were hospitalized with chronic kidney diseases in the last two months of 2017 harbored feelings of depression, mainly characterized by negative moods, poor sleep patterns and appetite issues. Two had suicidal thoughts.

More than 80 percent of the respondents said they felt frustrated and had little passion for anything.

Fu Lili, director of the hospital's social work department, cited the example of a 9-year-old boy who received a successful kidney transplant last year but was then found to be seriously depressed.

"He said there was no possibility that he could ever catch up with others, and he felt guilty for being an economic burden on his family," she said. "He said his elder brother lost his girlfriend because he brought such a huge change to the family."

Recent research overseas has shown that anxiety and depression may slow a child's recovery or even worsen his or her condition, said Zhu Daqian, a member of the Shanghai Medical Association's behavioral medicine branch. It can also make them less cooperative with doctors and slow down the process of returning to school and family life, she said.

"We also saw actual cases in Shanghai where anxiety or depression leads to blood glucose variability for children suffering from diabetes, and makes the condition of children suffering inflammatory bowel disease more severe," Zhu said. "Some children feel hopeless about their future, indulging in digital games and TV programs all day long or showing zero willingness to communicate."