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

Yıl 2017, Cilt: 15 Sayı: 3, 26 - 32, 01.12.2017

Aslı Sürer Adanır , Gülseren Taşkıran Cem Koparan Esin Özatalay

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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