Beta talasemili ergenlerde sosyal, duygusal ve davranışsal güçlüklerin ve ebeveynlerinde psikopatolojinin değerlendirilmesi

Öz

GİRİŞ ve AMAÇ: Bu çalışmada, beta-globin sentezinde defekt nedeniyle ortaya çıkan azalmış eritrosit sentezi, anemi ve demir birikimiyle karakterize kalıtsal bir kronik hastalık olan beta-talasemili ergenlerde sosyal, duygusal ve davranışsal güçlüklerin ve ebeveynlerinde psikopatoloji yaygınlığının değerlendirilmesi amaçlanmıştır. 
YÖNTEM ve GEREÇLER: 24 Beta-talasemili ergen ve ulaşılabilen ebeveyn hasta grubu; daha önce fiziksel ve mental hastalık öyküsü bulunmayan, yaş ve cinsiyet açısından eşleştirilmiş 20 ergen ve ulaşılabilen ebeveyn de kontrol grubu olarak çalışmaya dahil edilmiştir. Ergenlerde işlevsellik Güçler-Güçlükler Anketi (GGA) ile değerlendirilmiştir. Ebeveynlerde psikopatolojiyi değerlendirmek için 90 itemlik bir özbildirim ölçeği olan Ruhsal Belirti Tarama Listesi 90-R (RBTL 90-R) kullanılmıştır.
BULGULAR: Talasemili ergenlerde GGA yaşıt ilişkileri, emosyonel semptomlar ve total güçlük subskorları, bu alanlarda soruna işaret eder şekilde anlamlı olarak daha yüksek bulundu.
Ebeveynlerde, hasta grubunda yüksek çıkan obsesif-kompulsif skalası hariç, tüm RBTL 90-R alt skorları ve genel semptom indeks skoru her iki grupta normal sınırlarda olsa da, ailede ikinci bir talasemili çocuk varlığı ile ebeveynlerde anksiyete düzeyi arasında anlamlı bir ilişki saptandı. Benzer şekilde, çocukta dismorfi varlığında tüm alt skorlar ve genel semptom indeksi skoru anlamlı olarak artmaktaydı. Ancak çocukta talasemi komplikasyon(lar)ının varlığı ile benzer bir korelasyon saptanmadı.
TARTIŞMA ve SONUÇ: Hastalığın kronik ve ölümcül oluşu, tedaviye bağlı zorluklar ve demir birikimine bağlı ortaya çıkan ikincil rahatsızlıklar nedeniyle hasta çocukta ve ebeveynlerde psikolojik ve sosyal sorunlar görülebilmektedir. Bu nedenle tıbbi tedavinin psikososyal destekle kombine edilmesi, çocuk-aileyi bir bütün olarak ele almak ve olası psikopatolojilerin tanısı ve tedavisi bir gerekliliktir.

The social, emotional and behavioral difficulties in thalassemic adolescents and psychopathology in their parents

Aslı Sürer Adanır¹, Gülseren Taşkıran², Cem Koparan², Esin Özatalay^1
1Akdeniz University School Of Medicine, Department Of Child And Adolescent Psychiatry, Antalya
²Antalya Training And Research Hospital, Department Of Child And Adolescent Psychiatry, Antalya

INTRODUCTION: The aim of this study is to investigate the social, emotional and behavioral difficulties in adolescents and the prevalance of pyschopatology in parents of adolescents with βeta-thalassemia, a chronic disease which is a hereditary blood disorder characterized by reduced or absent beta globin chain synthesis, resulting in decreased red blood cell production, anemia and subsequent secondary diseases as a result of iron loading.
METHODS: For this aim, 24 adolescents with Beta-thalassemia and accessible parent, as the study group and 20 adolescents without any physical or mental problems and accessible parent, as the control group were recruited. Functionality of adolescents was assessed with Strengths and Difficulties Questionnaire (SDQ) and psychopatology in parents was assessed with The Symptom Checklist 90-R (SCL 90-R), a self-report questionnaire consisting of 90 items.
RESULTS: In thalassemic adolescents, SDQ subscores in peer relations, emotional symptoms and total difficulties were significantly higher, indicating problems in these areas.
In both groups, all SCL 90-R subscale scores and general symptom index score were in normal range, but obsessive-compulsive score was statistically higher in thalassemia group.
There was a significant correlation between the anxiety subscores of parents and presence of dismorfism in the thalassemic child. The presence of a second child with thalassemia in the family also correlated with the overall psychopathology in parents. But contrary to expectation, in the presence of thalassemia complication(s), no correlation was found.

DISCUSSION AND CONCLUSION: Because of the the chronic and fatal nature of the disease, difficulties about the treatment and secondary diseases due to the iron overload, psychological and social problems can be seen in the patients and their parents. In this respect, it’s a necessity to combine the medical treatment with psychosocial support, handle the child and the family as a whole and ensure the identification and treatment of any possible psychopathologies.

Keywords: Chronic disease, Beta-Thalassemia, adolescent, parents, psychosocial difficulties, psychopathology

Anahtar Kelimeler

• Kronik hastalık,Beta-Talasemi,ergen,ebeveyn,psikososyal güçlükler

Kaynakça

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