Marciano Renata C, Cardoso Maíra Gloria F, Vasconcelos Monica M A, Paula Jonas J, Oliveira Eduardo A, Lima Eleonora M
Department of Psychiatry, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Psychology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
J Pediatr Urol. 2020 Dec;16(6):838.e1-838.e7. doi: 10.1016/j.jpurol.2020.09.014. Epub 2020 Sep 16.
Lower urinary tract dysfunction (LUTD) is a common clinical condition in children, frequently associated with emotional issues both among the patients and their families. The objective of the present study was to measure depressive and anxious symptoms and quality of life (QoL) in parents of LUTD patients.
This cross-sectional study applied Beck Depression and Anxiety Inventories and WHOQOL-Bref to 88 caregivers of children with LUTD followed at a tertiary care center. The prevalence of mental disorders in children and adolescents was assessed using the Child Behavior Check List (CBCL 6-18) answered by their caregivers. The association of clinical features and emotional aspects related to the caregivers' quality of life was evaluated through non-parametric correlation (Spearman) and multiple linear regression analysis.
Most of the caregivers were mothers (88%), with a mean age of 41.5 (SD 8.7 years), 67% of them married or in a stable union, and 38% had not completed elementary school. Considering 19 as the cutoff point for the Beck scale, 44% of the sample had a clinical score for depressive symptoms and 43% for anxious symptoms. According to the parents' report, 56% of children with LUTD had a clinical score for behavioral problems in CBCL. Parents' QoL was impaired, and the predictors of poor QoL were the age of the patients and presence of depressive/anxious symptoms in caregivers. Parents' depression/anxiety symptoms and poor QoL significantly correlated with behavioral problems in their children. The CBCL total problems score correlated both to depression (r = 0.38, p < 0.01) and to anxiety in parents (r = 0.49, p < 0.01) (Figure).
These findings indicate a possible emotional impact of LUTD in patients' caregivers. Our study suggests that an approach to the family of LUTD patients' may be an important therapeutic resource for an effective clinical control of this condition.
下尿路功能障碍（LUTD）是儿童常见的临床病症，常与患者及其家庭的情绪问题相关。本研究的目的是测量LUTD患者父母的抑郁和焦虑症状以及生活质量（QoL）。
这项横断面研究对一家三级护理中心随访的88名LUTD患儿的照料者应用了贝克抑郁和焦虑量表以及世界卫生组织生活质量简表（WHOQOL-Bref）。使用照料者回答的儿童行为检查表（CBCL 6 - 18）评估儿童和青少年精神障碍的患病率。通过非参数相关性（Spearman）和多元线性回归分析评估与照料者生活质量相关的临床特征和情感方面的关联。
大多数照料者为母亲（88%），平均年龄41.5岁（标准差8.7岁），其中67%已婚或处于稳定关系，38%未完成小学教育。以贝克量表19分为临界值，44%的样本有抑郁症状临床评分，43%有焦虑症状临床评分。根据父母报告，56%的LUTD患儿在CBCL中有行为问题临床评分。父母的生活质量受损，生活质量差的预测因素是患者年龄以及照料者存在抑郁/焦虑症状。父母的抑郁/焦虑症状和生活质量差与孩子的行为问题显著相关。CBCL总问题得分与父母的抑郁（r = 0.38，p < 0.01）和焦虑（r = 0.49，p < 0.01）均相关（图）。
这些发现表明LUTD可能对患者照料者产生情感影响。我们的研究表明，针对LUTD患者家庭的干预可能是有效临床控制该病症的重要治疗资源。
