First Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Pediatr Allergy Immunol. 2010 Jun;21(4 Pt 2):e667-73. doi: 10.1111/j.1399-3038.2009.00896.x. Epub 2009 Sep 9.
We wanted to find out, whether the number of depressive symptoms is higher amongst asthmatic children's caregivers, compared to international data, to the Hungarian population average, and to parents of children with chronic renal disease. Are these depressive symptoms connected to the children's psychological status, asthma severity or current asthma symptoms? One-hundred and eight, 7- to 17-yr-old asthmatic children were enrolled, who have been treated at the Semmelweis University, First Department of Pediatrics. Children were suffering from asthma for at least 1 yr, with a median of 8 yr (1-16 yr), they started to develop asthmatic symptoms between the age of 0.5-14 yr (median: 3 yr). We also identified 27 children with chronic renal diseases and their caregivers, who functioned as a control group. Children were asked to complete the Hungarian-validated versions of the Child Depression Inventory, the Spielberger State Anxiety Inventory for Children and the Juniper Pediatric Asthma Quality of Life Questionnaire. Asthma severity and current symptoms were also documented, 56% had no symptoms on the preceding week. Caregivers were asked to complete the Hungarian versions of the Beck Depression Inventory (BDI) short form, the Spielberger Anxiety Inventory and the Juniper Pediatric Asthma Caregivers' Quality of Life Questionnaire. Caregivers of asthmatic children had significantly more depressive symptoms (7.73 +/- 6.69 s.d.) than the age-specific normal population (p < 0.01). Caregivers of renal patients also experience more depressive symptoms (9.61 +/- 7.43 s.d.) than their healthy peers, but difference between the two chronic diseases' group did not prove to be significant. Asthmatic children's caregivers who scored more points on the BDI than the population average suffer from more anxiety symptoms, but their quality of life is not worse than the caregivers' with less depressive points. Depressive symptoms were neither connected to the children's psychological and asthmatic symptoms nor quality of life. Amongst caregivers of asthmatic children, at least mild depressive symptoms were represented amongst 39% of men and 33% of women. Gender difference was not significant, despite observations in the normal Hungarian population. Amongst caregivers of renal patients, depressive symptoms were represented in 14% of men and 50% of women. Gender difference was significant. (p = 0.05). Significant difference was observed between male asthmatic and renal caregivers, albeit difference was not significant between the female groups. No difference was found in depressive symptoms according to caregivers' level of education. Caregivers of children with asthma have more depressive symptoms than the average Hungarian population, but their results do not differ from caregivers taking care of children with chronic renal diseases. Caregivers of asthmatic children having at least mild depressive symptoms tend to have higher anxiety symptoms as well. Up to date, childhood chronic disease management and long-term care should also focus on parental psychology, mainly on depression and anxiety, as prevalence is higher than in the average population.
我们想了解哮喘儿童的照顾者的抑郁症状数量是否高于国际数据、匈牙利人口平均值和慢性肾脏疾病儿童的父母。这些抑郁症状是否与儿童的心理状况、哮喘严重程度或当前哮喘症状有关?我们招募了 108 名 7-17 岁的哮喘儿童,他们在森梅威思大学第一儿科接受治疗。这些儿童患有哮喘至少 1 年,中位数为 8 年(1-16 年),他们在 0.5-14 岁(中位数:3 岁)之间开始出现哮喘症状。我们还确定了 27 名患有慢性肾脏疾病的儿童及其照顾者作为对照组。儿童被要求完成匈牙利语验证的儿童抑郁量表、儿童斯皮尔伯格状态焦虑量表和朱尼尔儿科哮喘生活质量问卷。还记录了哮喘严重程度和当前症状,56%的儿童在前一周没有症状。照顾者被要求完成匈牙利语版贝克抑郁量表(BDI)短表、斯皮尔伯格焦虑量表和朱尼尔儿科哮喘照顾者生活质量问卷。哮喘儿童的照顾者的抑郁症状明显多于特定年龄的正常人群(p < 0.01)。肾病患者的照顾者也经历了更多的抑郁症状(7.73 +/- 6.69 s.d.)比他们健康的同龄人,但两组慢性疾病之间的差异没有统计学意义。BDI 评分高于人群平均值的哮喘儿童照顾者患有更多的焦虑症状,但他们的生活质量并不比抑郁症状较少的照顾者差。抑郁症状与儿童的心理和哮喘症状以及生活质量无关。在哮喘儿童的照顾者中,至少有 39%的男性和 33%的女性存在轻度抑郁症状。尽管在正常的匈牙利人群中观察到了这种情况,但性别差异并不显著。在肾病患者的照顾者中,14%的男性和 50%的女性存在抑郁症状。性别差异有统计学意义(p = 0.05)。虽然在女性组中没有显著差异,但在哮喘和肾病的男性照顾者中观察到了显著差异。根据照顾者的教育程度,没有发现抑郁症状的差异。哮喘儿童的照顾者比匈牙利普通人群的抑郁症状更多,但他们的结果与照顾慢性肾脏疾病儿童的照顾者没有不同。患有至少轻度抑郁症状的哮喘儿童的照顾者往往也有更高的焦虑症状。迄今为止,儿童慢性疾病的管理和长期护理也应关注父母的心理,主要关注抑郁和焦虑,因为患病率高于普通人群。