Nur Yilmaz R Burcu, Germeç Çakan Derya, Türkyilmaz Uyar Ece
Yeditepe University, Faculty of Dentistry, Department of Orthodontics.
Department of Psychiatry, Şişli Etfal Hospital, Istanbul, Turkey.
J Craniofac Surg. 2019 Oct;30(7):2227-2232. doi: 10.1097/SCS.0000000000006028.
The aim was to evaluate the anxiety and depression of both the father and mother of an infant with cleft lip and palate (CLP) before, during and after nasoalveolar molding (NAM) therapy and before and after the lip surgery.
Forty mothers (age range: 18-36; mean ± SD: 23.6 ± 4.51) and 40 fathers (age range: 19-40; mean ± SD: 26.9 ± 4.69) of infants with CLP were asked to answer the 21-item Beck Depression as well as Anxiety Inventory (BDI and BAI) at 1 week after birth and before any intervention (T1), after impression taking (T2), after 2 months of NAM (T3), immediate before primary surgery (T4) and approximately 1 month of recovery after surgery (T5).
Maternal and paternal depression levels between T1, T2, T3, T4, and T5 showed significant differences (P < 0.05). The BDI scores decrease from T2 to T3 and T4 to T5. The increases of scores from T3 to T4 were significant (P < 0.05). The maternal depression and anxiety levels were higher than the paternal ones in all time periods. The BDI and BAI levels were lesser in mothers and fathers of babies with unilateral than bilateral CLP (P < 0.05).
Hence realizing of recovery, being in contact with the cleft team and other families, and having an active role in the therapy, the maternal and parental well-being increase with NAM therapy. However, depression and anxiety levels significantly increase before the lip surgery. It may be recommended that the cleft team deliver information and psychological support especially at birth and before the surgical approaches.
评估唇腭裂（CLP）患儿的父母在鼻牙槽塑形（NAM）治疗前、治疗期间、治疗后以及唇裂修复手术前和手术后的焦虑和抑郁情况。
40名唇腭裂患儿的母亲（年龄范围：18 - 36岁；平均±标准差：23.6 ± 4.51）和40名父亲（年龄范围：19 - 40岁；平均±标准差：26.9 ± 4.69）被要求在婴儿出生后1周且在任何干预之前（T1）、取模后（T2）、NAM治疗2个月后（T3）、初次手术前即刻（T4）以及手术后大约1个月恢复时（T5），回答21项贝克抑郁量表以及焦虑量表（BDI和BAI）。
母亲和父亲在T1、T2、T3、T4和T5时的抑郁水平存在显著差异（P < 0.05）。BDI得分从T2到T3以及从T4到T5有所下降。从T3到T4得分的增加具有显著性（P < 0.05）。在所有时间段，母亲的抑郁和焦虑水平均高于父亲。单侧唇腭裂患儿的母亲和父亲的BDI和BAI水平低于双侧唇腭裂患儿（P < 0.05）。
因此，随着对恢复情况的了解、与腭裂治疗团队及其他家庭的接触以及在治疗中发挥积极作用，母亲和父亲在NAM治疗期间幸福感增加。然而，在唇裂修复手术前抑郁和焦虑水平显著增加。建议腭裂治疗团队尤其在患儿出生时及手术前提供信息和心理支持。
