Romatizmal Kalp Hastalığı Olan Çocuk ve Ergenlerde Psikiyatrik Problemler ve Bunları Etkileyen Faktörler: Bir Ön Çalışma

Yıl 2019, Cilt: 17 Sayı: 3, 359 - 373, 02.12.2019

Merve Cikili Uytun , Serkan Fazlı Çelik Fatih Hilmi Çetin Zehra Babadağı Salih Uytun

Öz

GİRİŞ: Romatizmal kalp hastalığı olan çocuk ve ergenlerde psikiyatrik belirtilerin yanı sıra yaşam kalitesini ve hangi faktörlerin bu psikiyatrik sorunlara katkıda bulunduğunu belirlemeyi amaçladık.

GEREÇ ve YÖNTEM: Romatizmal kalp hastalığı olan toplam 25 çocuk ve ergen, ayrıca, 6-16 yaş arası 25 çocuk ve ergen kontrol grubu olarak dahil edildi. Okul Çağı Çocukları ç n Duygulanım Bozuklukları ve zofren Gör şme Ç zelges - imdi ve Yaşamboyu ekli (ÇD G- Y) t m çocuk ve ergenlerin ebeveynlerine uygulandı ve Çocuklarda Depresyon Envanteri, Spielberger Durumluluk ve S reklilik Kaygı Envanteri ve KINDLR Anketi Çocuk ve Ergenlerde Sağlığa lişkin Yaşam Kalitesinin Ölç lmesi için t m çocuk ve ergenlere uygulanmıştır. Anneleri değerlendirmek için, Beck Depresyon Envanteri, Beck Anksiyete Envanteri ve Beş Faktör Kişilik Envanteri kullanılmıştır.

BULGULAR: Romatizmal kalp hastalığı olan çocuk ve ergenlerde anksiyete puanlarının ve anksiyete bozukluğu tanısının y ksek olduğunu bulduk (p <0.05). Annelerin kaygı puanları, depresyon puanları ve kişilik özellikleri KINDL alt ölçekleri ile ilişkili idi ve kişilik özelliklerinden nevrotiklik puanları da Çocuk Depresyon Ölçeği puanları ile ilişkili olarak bulundu. Ayrıca, psikiyatrik bozukluk varlığının, Beck anksiyete skorları ile tahmin edilebildiğini bulduk.

SONUÇ: Sonuçlarımız, psikiyatrik değerlendirmenin, romatizmal kalp hastalığı olan çocukların ve ergenlerin ve ebeveynlerinin tedavisinde önemli olduğunu göstermektedir.

Anahtar Kelimeler

Romatizmal kalp hastalığı, çocuklar, anneleri

Psychiatric Problems in Children and Adolescents with Rheumatic Heart Disease and Which Factors Affect Them: A Prelımınary Study

Öz

INTRODUCTION: We aimed to evaluate the psychiatric symptoms in addition to quality of life in children and adolescents with rheumatic heart disease, and to determine which factors contribute to psychiatric problems of them.

MATERIALS and METHODS: A total of 25 children and adolescents with rheumatic heart disease, additionally, 25 children and adolescents with typical developing controls aged 6–16 years old were included. Kiddie-Schedule for Affective Disorders and Schizophrenia, (present and life time version – K-SADS-PL) was applied to parents of all of the children and adolescents, and Child Depression Inventory, The Spielberger State-Trait Anxiety Inventory for children KINDLR Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents were applied to all of the children and adolescents. Assessment for mothers, Beck Depression Inventory, Beck Anxiety Inventory and Five Factor Personality Inventory were used.

RESULTS: We found higher anxiety scores and increased anxiety disorder diagnosis among children and adolescents with rheumatic heart disease (p<0.05). Mothers’ anxiety scores, depression scores, and personality traits are associated with KINDL subscales, and neuroticism scores are also associated with Child Depression Inventory scores. In addition, presence of psychiatric disorder was predicted by Beck anxiety scores.

Kaynakça

• 1. Narin N, Mutlu F, Argun M, Ozyurt A, Pamukcu O, Baykan A, et al. Incidence and clinical features of acute rheumatic fever in Kayseri, Central Anatolia, 1998–2011. Cardiology in the Young. 2015;25(4):745-51.
• 2. Cilliers AM. Rheumatic fever and its management. Bmj. 2006;333(7579):1153-6.
• 3. Brosig C, Mussatto K, Kuhn E, Tweddell J. Psychosocial outcomes for preschool children and families after surgery for complex congenital heart disease. Pediatric cardiology. 2007;28(4):255-62.
• 4. Varni JW, Burwinkle TM, Lane MM. Health-related quality of life measurement in pediatric clinical practice: an appraisal and precept for future research and application. Health and quality of life outcomes. 2005;3(1):34.
• 5. Zoair AM, Elgohary TM, Seleem MA, Elamrosy DM, Amer SF, Saada SA. Psychosocial profile of a sample of Egyptian children with rheumatic heart disease. Middle East Current Psychiatry. 2015;22(2):114-9.
• 6. Cohen M, Mansoor D, Langut H, Lorber A. Quality of life, depressed mood, and self-esteem in adolescents with heart disease. Psychosomatic medicine. 2007;69(4):313-8.
• 7. Uzark K, Jones K, Slusher J, Limbers CA, Burwinkle TM, Varni JW. Quality of life in children with heart disease as perceived by children and parents. Pediatrics. 2008;121(5):e1060-e7.
• 8. Jackson AC, Frydenberg E, Liang RP-T, Higgins RO, Murphy BM. Familial impact and coping with child heart disease: a systematic review. Pediatric Cardiology. 2015;36(4):695-712.
• 9. Woods NF, Haberman MR, Packard NJ, Jensen L, Strickland OL. Demands of illness and individual, dyadic, and family adaptation in chronic illness. Western Journal of Nursing Research. 1993;15(1):10-30. Uytun Çıkılı M ve ark. Romatizmal Kalp Hastalığı ve Psikiyatrik Sorunlar JCP2019;17:(3):359-373 372
• 10. Lawoko S, Soares JJ. Distress and hopelessness among parents of children with congenital heart disease, parents of children with other diseases, and parents of healthy children. Journal of psychosomatic research. 2002;52(4):193-208.
• 11. Vrijmoet-Wiersma CJ, Ottenkamp J, van Roozendaal M, Grootenhuis MA, Koopman HM. A multicentric study of disease-related stress, and perceived vulnerability, in parents of children with congenital cardiac disease. Cardiology in the Young. 2009;19(6):608-14.
• 12. Doherty N, McCusker CG, Molloy B, Mulholland C, Rooney N, Craig B, et al. Predictors of psychological functioning in mothers and fathers of infants born with severe congenital heart disease. Journal of Reproductive and Infant Psychology. 2009;27(4):390-400.
• 13. Arafa MA, Zaher SR, El-Dowaty AA, Moneeb DE. Quality of life among parents of children with heart disease. Health and Quality of Life Outcomes. 2008;6(1):91.
• 14. Lazarus RS, Folkman S. Stress, appraisal, and coping: Springer publishing company; 1984.
• 15. Gökler B, Ünal F, Pehlivant rk B, K lt r EÇ, Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADS-PL-T). Turkish Journal of Child and Adolescent Mental Health. 2004;11(3):109-16.
• 16. Kovacs M. Rating scales to assess depression in school-aged children. Acta Paedopsychiatrica: International Journal of Child & Adolescent Psychiatry. 1981.
• 17. Spielberger CD. State‐Trait anxiety inventory: Wiley Online Library; 2010.
• 18. Ravens-Sieberer U, Erhart M, Wille N, Wetzel R, Nickel J, Bullinger M. Generic health-related quality-of-life assessment in children and adolescents. PharmacoEconomics. 2006;24(12):1199-220.
• 19. Beck A, Steer R. Beck Depression Inventory. The Psychological Corporation Harcourt Brace Jovanovich. Inc, Pages. 1987.
• 20. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology. 1988;56(6):893.
• 21. TATAR A. Beş Faktör Kişilik Ölçeğinin Kısa Formunun geliştirilmesi. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi. 2016;17.
• 22. Coffey PM, Ralph AP, Krause VL. The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: A systematic review. PLoS neglected tropical diseases. 2018;12(6):e0006577.
• 23. Ör n UA, Ceylan Ö, Bilici M, Karademir S, Öcal B, enocak F, et al. Acute rheumatic fever in the Central Anatolia Region of Turkey: a 30-year experience in a single center. European journal of pediatrics. 2012;171(2):361-8.
• 24. Olgunturk R, Canter B, Tunaoglu FS, Kula S. Review of 609 patients with rheumatic fever in terms of revised and updated Jones criteria. International journal of cardiology. 2006;112(1):91-8.
• 25. Al-Munibari AN, Nasher TM, Ismail SA, Mukhtar E-DA. Prevalence of rheumatic fever and rheumatic heart disease in Yemen. Asian Cardiovascular and Thoracic Annals. 2001;9(1):41-4.
• 26. Moon JR, Huh J, Kang I-S, Park SW, Jun T-G, Lee HJ. Factors influencing depression in adolescents with congenital heart disease. Heart & Lung: The Journal of Acute and Critical Care. 2009;38(5):419-26.
• 27. Essawy MA, Bahgat ZS, Kassem HA. Health-related quality of life of school- age children with rheumatic Fever. The Journal of the Egyptian Public Health Association. 2010;85(3-4):205-22.
• 28. Brage D, Campbell‐Grossman C, Dunkel J. Psychological correlates of adolescent depression. Journal of Child and Adolescent Psychiatric Nursing. 1995;8(4):23-30.
• 29. Yamey G, Greenwood R. Religious views of the ‘medical’rehabilitation model: a pilot qualitative study. Disability and Rehabilitation. 2004;26(8):455-62.
• 30. Tartakovsky E, Hamama L. Mothers’ acceptance-rejection of their children infected with HIV: The role of the mothers’ social axioms, psychological distress, and relationships with the partner. Journal of pediatric psychology. 2011;36(9):1030-42.
• 31. Goldberg S, Morris P, Simmons RJ, Fowler RS, Levison H. Chronic illness in infancy and parenting stress: a comparison of three groups of parents. Journal of pediatric psychology. 1990;15(3):347-58.
• 32. Oerter R, Montada L. Entwicklungspsychologie: Beltz PVU Weinheim; 2002.
• 33. Lewis C, Knopf D, Chastain-Lorber K, Ablin A, Zoger S, Matthay K, et al. Patient, parent, and physician perspectives on pediatric oncology rounds. The Journal of pediatrics. 1988;112(3):378-84.
• 34. McCrae RR, Costa Jr PT. Personality trait structure as a human universal. American psychologist. 1997;52(5):509.
• 35. Santor DA, Rosenbluth M. Evaluating the contribution of personality factors to depressed mood in adolescents: conceptual and clinical issues. Depression and personality: Conceptual and clinical challenges. 2005;22(1):229-66