Department of Child and Adolescent Psychiatry, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey.
Department of Child Health and Diseases Hematology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Psychooncology. 2019 Oct;28(10):1995-2001. doi: 10.1002/pon.5179. Epub 2019 Aug 8.
To analyze the development of psychopathology in recipients along with their donor and nondonor siblings and the relationship with the bone marrow transplantation (BMT) process.
All children were interviewed using the Kiddie Schedule for Affective Disorders and Schizophrenia to assess psychopathology. The depression and anxiety symptoms and self-esteem of children and adolescents were evaluated using the Children's Depression Inventory, State-Trait Anxiety Inventory for Children, State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale.
In this study, the depressive symptom level was found significantly higher in the donor group compared with the nondonor group. State anxiety symptoms were higher in the BMT group (P < .05). There were no significant differences in trait anxiety symptoms. Self-respect was higher in children in the donor group compared with those in the BMT group (P < .05). During the transplant process, children with bone marrow transplants had a higher prevalence of depression, anxiety disorder, and attention-deficit/hyperactivity disorder, and nondonor siblings had a higher prevalence of depressive disorder, anxiety disorder, and attention-deficit/hyperactivity disorder compared with society in general.
Physicians should deal with the family as a whole, not just their patient, and should be aware of the psychiatric risk of other siblings during the assessment.
分析受者及其供者和非供者兄弟姐妹的精神病理学发展情况,以及与骨髓移植(BMT)过程的关系。
所有儿童均采用儿童心境障碍和精神分裂症谱系 Kiddie 筛查表进行精神病理学评估。采用儿童抑郁量表、儿童状态-特质焦虑量表、状态-特质焦虑问卷和罗森伯格自尊量表评估儿童和青少年的抑郁症状、焦虑症状和自尊。
本研究中,供者组的抑郁症状水平显著高于非供者组。BMT 组的状态焦虑症状更高(P <.05)。特质焦虑症状无显著差异。与 BMT 组相比,供者组的儿童自尊心更高(P <.05)。在移植过程中,骨髓移植患儿的抑郁障碍、焦虑障碍和注意缺陷多动障碍患病率较高,而非供者兄弟姐妹的抑郁障碍、焦虑障碍和注意缺陷多动障碍患病率也高于一般人群。
医生在评估时应将整个家庭而非仅仅患者作为治疗对象,并注意其他兄弟姐妹的精神风险。