Conijn Thirsa, Nijmeijer Stephanie C M, van Oers Hedy A, Wijburg Frits A, Haverman Lotte
Department of Pediatric Metabolic Diseases, Emma Children's Hospital and Lysosome Center 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Psychosocial Department, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
JIMD Rep. 2019;44:33-41. doi: 10.1007/8904_2018_119. Epub 2018 Jul 7.
Mucopolysaccharidosis type III (MPS III or Sanfilippo syndrome) is a lysosomal storage disease resulting in progressive neurocognitive decline during childhood and early demise. Its diagnosis may have a great impact on parents, potentially leading to psychosocial problems such as anxiety, depression, parental distress, and posttraumatic stress.
Twenty-six mothers and 19 fathers of 34 Dutch MPS III patients completed the "Hospital Anxiety and Depression Scale" (HADS), the "Distress Thermometer for Parents" (DT-P), and the "Self-Rating Scale for Posttraumatic Stress Disorders" (SRS-PTSD). Independent-sample T-tests and chi-square tests were used to assess differences between parents of MPS III patients and reference groups regarding anxiety and depression (HADS), distress (DT-P), and posttraumatic stress (SRS-PTSD).
Mothers met the criteria for clinically relevant anxiety (50%) and depression (34.6%) more frequently compared to reference mothers (p = 0.001). Fathers more often met the criteria for clinically relevant depression (36.8%) compared to reference fathers (p = 0.022). Clinically relevant distress was highly prevalent in mothers (84.6%) and fathers (68.4%) of MPS III patients compared to reference parents (p < 0.01). Finally, the prevalence of PTSD was strikingly higher in both mothers (26.9%) and fathers (15%) than reported in the general Dutch population (respectively, p < 0.001 and p < 0.05).
We report a clinically relevant impact of parenting an MPS III patient on psychosocial functioning, which is demonstrated by high levels of anxiety, depression, distress, and a remarkably high prevalence of PTSD. Structural monitoring of the psychosocial functioning of MPS III parents is therefore essential and may be beneficial for the whole family.
Ⅲ型黏多糖贮积症(MPS III或Sanfilippo综合征)是一种溶酶体贮积病,可导致儿童期进行性神经认知衰退并过早死亡。其诊断可能对父母产生重大影响,可能导致心理社会问题,如焦虑、抑郁、父母苦恼和创伤后应激障碍。
34名荷兰MPS III患者的26名母亲和19名父亲完成了“医院焦虑抑郁量表”(HADS)、“父母苦恼温度计”(DT-P)和“创伤后应激障碍自评量表”(SRS-PTSD)。采用独立样本t检验和卡方检验评估MPS III患者父母与对照组在焦虑和抑郁(HADS)、苦恼(DT-P)以及创伤后应激(SRS-PTSD)方面的差异。
与对照组母亲相比,MPS III患者的母亲更频繁地符合临床相关焦虑(50%)和抑郁(34.6%)的标准(p = 0.001)。与对照组父亲相比,MPS III患者的父亲更常符合临床相关抑郁的标准(36.8%)(p = 0.022)。与对照组父母相比,MPS III患者的母亲(84.6%)和父亲(68.4%)中临床相关苦恼的发生率很高(p < 0.01)。最后,母亲(26.9%)和父亲(15%)中创伤后应激障碍的患病率均显著高于荷兰普通人群的报告患病率(分别为p < 0.001和p < 0.05)。
我们报告了抚养MPS III患者对心理社会功能的临床相关影响,表现为焦虑、抑郁、苦恼水平较高以及创伤后应激障碍的患病率显著升高。因此,对MPS III患者父母的心理社会功能进行结构性监测至关重要,可能对整个家庭有益。