Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Turkey.
Department of Child and Adolescent Psychiatry, İstanbul University Faculty of Medicine, İstanbul.
Turk J Pediatr. 2021;63(5):846-854. doi: 10.24953/turkjped.2021.05.012.
Cerebral palsy (CP) is the most common motor disability in childhood. In addition to motor impairment, it is frequently accompanied by intellectual disability (ID). We aimed to investigate the associations between motor functions, quality of life (QoL) and maternal psychopathology in children with CP of different intelligence levels.
In total, 37 children and adolescents (16 females and 21 males) between 4 and 18 years of age diagnosed with CP were recruited from a Pediatric Neurology Outpatient Clinic. Gross Motor Function Classification System (GMFCS) and Bimanual Fine Motor Function (BFMF) were used for the children`s motor functions assessment. Quality of life was determined by the caregivers with Pediatric Quality Of Life Inventory-Parent version (PedsQL-P). Maternal anxiety and depression levels were assessed using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI).
Moderate-severe ID (n=19)(13.5%, 37.8%) and normal IQ-mild ID (n=18) (32.4 %,16.2%) groups were evaluated in this study. GMFCS level 2 was more frequent in both groups. The majority of the severe-moderate ID group was at BFMF level 4, while the normal IQ-mild ID group was at BFMF level 2. PedsQL-P scores of children with CP, maternal BAI scores, and maternal BDI scores did not differ between the two groups (p > 0.05). Psychosocial PedsQL scores had a moderate negative correlation with the maternal BAI scores (r=- 0.41, p < 0.05). There was also a moderate positive correlations between the ages of children and maternal BDI scores (r=0.34, p < 0.05).
Our results demonstrated that maternal anxiety was correlated with psychosocial QoL in children with CP. Maternal depression scores increasing with the ages of the children with CP may also indicate the social support needs for mothers with children of chronic diseases. Further studies may reveal the associations with other biopsychosocial factors in children with CP of different intelligence levels by using longitudinal study designs with larger sample sizes.
脑瘫（CP）是儿童中最常见的运动障碍。除运动障碍外，脑瘫常伴有智力障碍（ID）。我们旨在研究不同智力水平的 CP 儿童的运动功能、生活质量（QoL）和母亲精神病理学之间的关联。
本研究共纳入 37 名 4 至 18 岁的脑瘫儿童和青少年（女性 16 名，男性 21 名），他们均来自儿科神经科门诊。使用粗大运动功能分类系统（GMFCS）和双手精细运动功能（BFMF）评估儿童的运动功能。使用儿童生活质量问卷-父母版（PedsQL-P）由照顾者评估生活质量。使用贝克焦虑量表（BAI）和贝克抑郁量表（BDI）评估母亲的焦虑和抑郁水平。
本研究评估了中度-重度 ID（n=19）（13.5%，37.8%）和正常 IQ-轻度 ID（n=18）（32.4%，16.2%）组。两组 GMFCS 水平均为 2 级。大多数严重-中度 ID 组处于 BFMF 水平 4，而正常 IQ-轻度 ID 组处于 BFMF 水平 2。CP 患儿的 PedsQL-P 评分、母亲的 BAI 评分和母亲的 BDI 评分在两组间无差异（p＞0.05）。心理社会 PedsQL 评分与母亲的 BAI 评分呈中度负相关（r=-0.41，p＜0.05）。儿童年龄与母亲 BDI 评分之间也呈中度正相关（r=0.34，p＜0.05）。
我们的结果表明，母亲的焦虑与 CP 儿童的心理社会生活质量相关。随着 CP 儿童年龄的增长，母亲的抑郁评分也随之升高，这可能表明患有慢性病儿童的母亲需要社会支持。进一步的研究可能会通过使用具有更大样本量的纵向研究设计来揭示不同智力水平的 CP 儿童与其他生物心理社会因素之间的关联。
