Dilek Tugce Damla, Boybay Zehra, Kologlu Nursena, Tin Oguzhan, Güler Serhat, Saltık Sema
Istanbul University-Cerrahpasa, Cerrahpasa Medicine Faculty, Department of Pediatric Neurology.
Istanbul University-Cerrahpasa, Cerrahpasa Medicine Faculty Department of Child and Adolescent Psychiatry.
Mult Scler Relat Disord. 2021 Jan;47:102595. doi: 10.1016/j.msard.2020.102595. Epub 2020 Oct 26.
The Severe Acute Respiratory Syndrome-CoV2 outbreak was announced a pandemic by the World Health Organization on March 11th, 2020. Both the pandemic itself and the restrictions were thought to create some psychological problems especially in patients with chronic illnesses such as Multiple Sclerosis (MS). This study was conducted to evaluate the impact of SARS-CoV2 pandemic on daily lives of children with MS, and the anxiety status of these patients and anxiety - depression status of their parents.
This study was performed on a group of pediatric MS patients aged 8-18 years in Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, and Child Neurology Department. Thirty patients with MS and their 30 parents were enrolled to the study. The control group consisted of 49 healthy, age- and sex-matched children and their 49 parents. The patients (and their parents) were asked to complete a web-based survey evaluating access to health care and other changes in daily life between March 11th, 2020 and June 1st, 2020. The State-Trait Anxiety Inventory (STAI) [which is composed of two parts; S-anxiety (STAI-S) and T-anxiety (STAI-T)] was administrated to the patients and healthy controls and the results were compared between the two groups to assess their anxiety levels. The Hospital Anxiety and Depression Scale (HAD) [which is composed of two parts; HAD-anxiety (HAD-A) and HAD-depression (HAD-D)] was also given to all parents. The results of the HAD tests were compared between the two groups statistically.
The results of the web-based survey showed that 4 of 9 (44.4%) patients, who had a regular workout program, left the program and 13 (43.3%) patients put on weight during the pandemic. Twenty-two patients (73.3%) could not get direct exposure to sunlight because of the curfew. Therefore, approximately half of the patients started to take vitamin D supplement. Most of the patients (80%) thought that they had higher risk and believed that they would have severe symptoms compared to healthy people. Twenty one (70%) patients disrupted their regular health checks and the most frequent causes were identified as closure of policlinics to routine patient care (33%) and concerns of getting SARS-CoV2 infection (26,6%). Two of 3 patients who had an MS attack did not go to the doctor during this period. The mean STAI-S scores in MS patients were significantly higher compared to the healthy controls (p=<0.001). The level of S-anxiety in all patients was higher compared to the cut off value.The mean HAD A score was found to be significantly higher in them compared to the parents of healthy individuals (p = 0.001).
Our results showed that children with MS had negative changes in daily life and high anxiety levels during the pandemic. Since MS patients have also psychiatric comorbidities, they may need psychosocial support especially in this period. Besides, establishment of separate health centers to be used during pandemics for children with chronic illnesses such as MS may be recommended to facilitate access to health care.
2020年3月11日,世界卫生组织宣布严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫情为大流行。人们认为,这场大流行本身以及相关限制措施会引发一些心理问题,尤其是在患有慢性病(如多发性硬化症,MS)的患者中。本研究旨在评估SARS-CoV-2大流行对MS患儿日常生活的影响,以及这些患者的焦虑状况及其父母的焦虑抑郁状况。
本研究对伊斯坦布尔大学锡拉丘兹帕夏医学院儿童神经科8至18岁的一组儿科MS患者进行。30例MS患者及其30名父母参与了研究。对照组由49名健康的、年龄和性别匹配的儿童及其49名父母组成。要求患者(及其父母)完成一项基于网络的调查,评估2020年3月11日至2020年6月1日期间获得医疗保健的情况以及日常生活中的其他变化。对患者和健康对照者进行状态-特质焦虑量表(STAI)[由两部分组成;状态焦虑(STAI-S)和特质焦虑(STAI-T)]测试,并比较两组结果以评估他们的焦虑水平。还对所有父母进行了医院焦虑抑郁量表(HAD)[由两部分组成;HAD焦虑(HAD-A)和HAD抑郁(HAD-D)]测试。对两组HAD测试结果进行统计学比较。
基于网络的调查结果显示,在疫情期间,9名(44.4%)有规律锻炼计划的患者中有4名停止了该计划,13名(43.3%)患者体重增加。22名患者(73.3%)由于宵禁无法直接接触阳光。因此,约一半的患者开始服用维生素D补充剂。大多数患者(80%)认为他们面临更高的风险,并且相信与健康人相比他们会出现严重症状。21名(7%)患者中断了常规健康检查,最常见的原因是门诊停止常规患者护理(33%)以及担心感染SARS-CoV-2(26.6%)。在此期间,3名MS发作的患者中有2名没有去看医生。MS患者的平均STAI-S得分显著高于健康对照者(p<0.001)。所有患者的状态焦虑水平均高于临界值。与健康个体的父母相比,他们的平均HAD-A得分显著更高(p = 0.001)。
我们的结果表明,在大流行期间,MS患儿的日常生活出现了负面变化,焦虑水平较高。由于MS患者还存在精神共病,他们可能尤其在此期间需要心理社会支持。此外,可能建议设立单独的健康中心,以便在大流行期间供MS等慢性病患儿使用以方便获得医疗保健。