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自闭症谱系障碍儿童父母的高抑郁症状和倦怠水平:一项多中心、横断面、病例对照研究。

High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study.

机构信息

Department of Child and Adolescent Psychiatry, Baskent University, Dr. Turgut Noyan Medical and Research Center, Adana, Turkey.

Department of Child and Adolescent Psychiatry, Bolu Abant İzzet Baysal University Medical Faculty, Bolu, Turkey.

出版信息

J Autism Dev Disord. 2021 Nov;51(11):4086-4099. doi: 10.1007/s10803-021-04874-4. Epub 2021 Jan 18.

Abstract

The diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inventory were used to evaluate parents' depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depression. More than half the parents sought CAM interventions. Education level did not affect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents' burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be beneficial for the family unit as a whole.

摘要

自闭症谱系障碍(ASD)患儿的诊断会影响家庭进程,增加育儿压力和婚姻冲突,并可能导致父母出现精神病理学。它也可能影响孩子的预后。本研究旨在确定 ASD 患儿父母与健康儿童父母相比,抑郁和倦怠水平及其预测因素。我们还试图评估父母补充和替代医学(CAM)干预的比率,并以探索性方式评估这种现象的相关性。共有 145 名 ASD 儿童和 127 名对照组儿童及其父母参加了研究。使用贝克抑郁量表和马斯拉赫倦怠量表评估父母的抑郁症状和倦怠水平。临床医生根据儿童自闭症评定量表评估 ASD 患儿的症状。通过社会人口统计学数据表格筛选家庭、儿童和 CAM 变量。在统计评估中使用描述性、双变量和相关性分析。使用多元回归分析评估倦怠的预测因素。与对照组相比,ASD 患儿父母的倦怠和抑郁水平显著升高。与父亲相比,母亲的倦怠水平显著升高,而与母亲相比,父亲的抑郁评分显著升高。母亲的倦怠与孩子存在功能性言语显著相关,而父亲的倦怠与父亲的职业显著相关。母亲的抑郁与父亲的抑郁、孩子言语缺失和孩子接受特殊教育服务相关。父亲的抑郁与自闭症症状严重程度和母亲的抑郁相关。超过一半的父母寻求 CAM 干预。教育水平不影响寻求 CAM 干预,而母亲和父亲的精神病理学以及孩子是否患有癫痫会增加对 CAM 方法的使用。应该为接受 ASD 诊断的孩子的父母提供心理支持。解决父母的倦怠和压力水平,并为他们提供有关 ASD 的病因和治疗知识的协商,可能对整个家庭单位都有益。

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