Saini Arun, Chandra Jagdish, Goswami Utpal, Singh Varinder, Dutta A K
Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India.
J Pediatr. 2007 May;150(5):516-20. doi: 10.1016/j.jpeds.2007.01.025.
To assess the prevalence and the spectrum of psychosocial morbidity and its correlation with various social and disease-related factors in children with beta thalassemia major.
Sixty children with transfusion-dependent beta thalassemia major were included in the study group who fulfilled these inclusion criteria: 1) age 5 to 15 years; 2) both parents alive and living together; 3) negative for human immunodeficiency virus; and 4) no family history of any chronic illness or psychological illness. The control group consisted of 60 children of matched age group and social background. A semi-structured interview and 2 preformed questionnaires (Pediatric Symptom Checklist [PSC] and Childhood Psychopathology Measurement Schedule [CPMS]) were used to assess psychosocial morbidity.
The mean score of the PSC was 11.63 +/- 3.79 (range, 7-24) in children with thalassemia, compared with 5.78 +/- 2.572 (range, 2-13) in the control group (P < .001). The mean score of the CPMS was 11.63 +/- 3.6 (range, 6-25) compared with 6.08 +/- 2.8 (range, 1-14) in the study and the control group, respectively (P < .001). Among the children with thalassemia, 54% had a mean CPMS score > or = 10 (which is considered significant for psychopathological disorders), compared with 8.3% in the control group (P < .001).
Children with thalassemia have significantly higher psychosocial morbidity. Psychosocial aspects need to be addressed in the overall treatment of children with thalassemia to prevent the development of clinically manifest psychological disease.
评估重型β地中海贫血患儿心理社会疾病的患病率、范围及其与各种社会和疾病相关因素的相关性。
研究组纳入60例依赖输血的重型β地中海贫血患儿,这些患儿符合以下纳入标准:1)年龄5至15岁;2)双亲健在且共同生活;3)人类免疫缺陷病毒检测阴性;4)无任何慢性疾病或心理疾病家族史。对照组由60名年龄匹配且社会背景相似的儿童组成。采用半结构化访谈和2份预编问卷(儿童症状清单[PSC]和儿童精神病理学测量量表[CPMS])评估心理社会疾病。
地中海贫血患儿PSC的平均得分为11.63±3.79(范围7 - 24),而对照组为5.78±2.572(范围2 - 13)(P <.001)。研究组和对照组CPMS的平均得分分别为11.63±3.6(范围6 - 25)和6.08±2.8(范围1 - 14)(P <.001)。在地中海贫血患儿中,54%的患儿CPMS平均得分≥10(这被认为对精神病理学障碍具有显著性),而对照组为8.3%(P <.001)。
地中海贫血患儿的心理社会疾病患病率显著更高。在重型地中海贫血患儿的整体治疗中需要关注心理社会方面,以预防临床上明显心理疾病的发生。