Pet ownership and parent-reported mental health in pediatric transplantation. A cross-sectional study from the European reference network Transplantchild. The pink study

Abstract

Introduction As the number of transplants and survival rates increase, concerns regarding the mental health of transplanted children and their correlated factors are growing. Objectives To assess the emotional, behavioral, and physical functioning of children who underwent various types of transplants, exploring its association with pet ownership. Methods Pediatric transplant centers were contacted through the European Network “TransplantChild”. Primary caregivers were invited to complete an online survey including demographic information and the Strengths and Difficulties Questionnaire (SDQ). Results A total of 418 participants from nine European centers were included. The mean age of the children was 11.09 ± 4.17 years. Of these, 84% had undergone solid-organ transplantation and 16% had undergone hematopoietic stem cell transplantation; 43% of the children lived with dogs and/or cats. High rates of abnormal scores were observed across all the SDQ subscales, with peer problems being the most prevalent (29.8%). Solid-organ transplant recipients exhibited higher conduct-problem scores (p < 0.001). Older children had significantly higher scores on emotional and peer problems (p < 0.001). Pet ownership was associated with higher prosocial behavior scores (p < 0.05), even after adjusting for clinical severity. No statistically significant interaction effect was found between transplant type and pet ownership in any SDQ domain. Moreover, among patients aged >12 years, pet ownership was linked to fewer peer-relationship problems (p < 0.05). Conclusions Transplanted children are at increased risk of emotional and behavioral difficulties. Pet ownership was associated with higher prosocial behavior and fewer peer problems in adolescents, supporting a potential beneficial role of companion animals in the psychosocial well-being of pediatric transplant recipients.