Amae Shintaro, Hayashi Junko, Funakosi Syunichi, Kamiyama Takamichi, Yoshida Shigehiko, Ueno Takashi, Matsuoka Hiroo, Hayashi Yutaka
Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Seiryo-cho 1-1, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
Pediatr Surg Int. 2008 Mar;24(3):293-8. doi: 10.1007/s00383-007-2077-5. Epub 2007 Nov 29.
Our purpose was to clarify factors that influence the level of depression of Japanese children with anorectal malformations (ARM). The subjects comprised 66 children with ARM, aged 0-16 years, and their mothers. Patients were divided into three groups (Group 1: aged 0-5 years, Group 2: 6-11 years, and Group 3: 12-16 years). The level of depression of the children aged 6-16 years was investigated by Kovac's children's depression inventory (CDI). The psychological status of their mothers was assessed by Spielberger's state-trait anxiety index (STAI) and Zung's self-rating depression scale (SDS). The classification of ARM and the clinical condition were also investigated. Defecation scores were assigned for the degree of bowel dysfunction. The level of depression in the patients was more marked in Group 3 than in Group 2 according to the CDI score. Significant correlations between the CDI score of the child and the STAI-1, STAI-2 and SDS scores of the mother were observed in Group 2, but not in Group 3. In Group 2, the STAI-1 score of the mothers was significantly influenced by the degree of bowel dysfunction in her child. In Group 3, the CDI score was significantly correlated with the constipation score. This study revealed that bowel dysfunction is the important factor that influences the level of depression of the children with ARM. In the period of childhood during which the child attends primary school, bowel dysfunction indirectly influences the level of depression of children through the psychological status of mothers. However, bowel dysfunction directly influences the level of depression of children in adolescent patients.
我们的目的是阐明影响日本肛门直肠畸形（ARM）患儿抑郁程度的因素。研究对象包括66名年龄在0至16岁的ARM患儿及其母亲。患者被分为三组（第1组：0至5岁，第2组：6至11岁，第3组：12至16岁）。采用科瓦茨儿童抑郁量表（CDI）对6至16岁儿童的抑郁程度进行调查。通过斯皮尔伯格状态-特质焦虑量表（STAI）和zung自评抑郁量表（SDS）评估其母亲的心理状态。还对ARM的分类和临床状况进行了调查。根据排便功能障碍程度给予排便评分。根据CDI评分，第3组患者的抑郁程度比第2组更明显。在第2组中观察到儿童的CDI评分与母亲的STAI-1、STAI-2和SDS评分之间存在显著相关性，但在第3组中未观察到。在第2组中，母亲的STAI-1评分受其孩子排便功能障碍程度的显著影响。在第3组中，CDI评分与便秘评分显著相关。本研究表明，排便功能障碍是影响ARM患儿抑郁程度的重要因素。在儿童上小学的时期，排便功能障碍通过母亲的心理状态间接影响儿童的抑郁程度。然而，排便功能障碍直接影响青少年患者的抑郁程度。
