Dokuz Eylul University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey; University of Health Sciences, Dr. Behçet Uz Children's Research and Training Hospital, Department of Pediatric Metabolism and Nutrition, Izmir, Turkey.
Kocaeli University Faculty of Medicine, Department of Pediatric Metabolism and Nutrition, Kocaeli, Turkey.
Arch Pediatr. 2021 Nov;28(8):702-706. doi: 10.1016/j.arcped.2021.09.008. Epub 2021 Oct 5.
This study aimed to investigate the frequency and status of depression and anxiety among mothers of children with inborn errors of metabolism (IEM) who were on a restricted diet and previously experienced metabolic crises.
This cross-sectional multicenter descriptive study included 93 children with IEM who were on restricted diet. The patients were divided into two groups: those who had experienced metabolic crises (n=44, urea cycle defect, organic acidemia, maple syrup urine disease, hereditary fructose intolerance) and those who had not experienced previous metabolic crises (n=49; phenylketonuria, galactosemia, and non-ketotic hyperglycinemia). The control group comprised 37 healthy children. The mothers of the patients and control participants answered a questionnaire about their and their children's demographic and clinical characteristics and completed the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-S and STAI-T).
The maternal BDI, STAI-S, and STAI-T scores were 6.3±5.2, 36.1±11.2, and 39.9±8.8, respectively, in the control group. The maternal BDI, STAI-S, and STAI-T scores of the children who had experienced (19.2±9.7; 44.0±12.4; 47.9±10.6) and those who had not experienced (13.9±9.1; 40.7 ±8.6; 45.3±8.3) a crisis were significantly higher than for the controls. The BDI score was significantly higher for the mothers of children who had experienced a crisis (p=0.011), whereas no significant difference was determined between the two patient groups regarding STAI-S and STAI-T scores. The mothers of four children who had experienced metabolic crises were on antidepressant therapy.
Although their children were on a similar restricted diet, the mothers of children who previously experienced or who had the risk of experiencing metabolic crises had higher depression scores as compared with the mothers of children who did not experience a previous crisis. Early supportive therapy may be required for the families of these patients to lower the burden of stress.
本研究旨在调查患有先天性代谢错误(IEM)且接受饮食限制的儿童的母亲中抑郁和焦虑的发生频率和状况,这些母亲此前曾经历过代谢危象。
本横断面多中心描述性研究纳入了 93 名接受饮食限制的 IEM 患儿。将患者分为两组:经历过代谢危象组(n=44,尿素循环缺陷、有机酸血症、枫糖尿症、遗传性果糖不耐受)和未经历过代谢危象组(n=49;苯丙酮尿症、半乳糖血症和非酮性高甘氨酸血症)。对照组由 37 名健康儿童组成。患儿及其母亲回答了一份关于其自身和子女人口统计学及临床特征的问卷,并完成了贝克抑郁量表(BDI)和状态特质焦虑量表(STAI-S 和 STAI-T)。
对照组母亲的 BDI、STAI-S 和 STAI-T 评分为 6.3±5.2、36.1±11.2 和 39.9±8.8。经历过(19.2±9.7;44.0±12.4;47.9±10.6)和未经历过(13.9±9.1;40.7±8.6;45.3±8.3)代谢危象的患儿母亲的 BDI、STAI-S 和 STAI-T 评分显著高于对照组。经历过代谢危象的患儿母亲的 BDI 评分显著高于对照组(p=0.011),而两组患儿的 STAI-S 和 STAI-T 评分无显著差异。有 4 名经历过代谢危象的患儿的母亲正在接受抗抑郁治疗。
尽管其子女接受了相似的饮食限制,但与未经历过代谢危象的患儿的母亲相比,此前经历过或有发生代谢危象风险的患儿的母亲抑郁评分更高。可能需要对这些患者的家庭进行早期支持性治疗,以减轻其压力负担。