Determination of Dietary Adherence and Frequency of Depressive Disorder in Adolescents with Phenylketonuria

Öz

Objective: To reveal the relationship between blood phenylalanine level and psychological state is important in phenylketonuria. In spite of phenylketonuria is one of the most common diseases seen in Turkey there is no studies on the prevalence of depression in adolescents. The aim of this study is to determine the adherence to diet and frequency of depressive disorder in adolescents with phenylketonuria.

Material and Methods: This study was conducted with adolescents with phenylketonuria between November and April 2019. Adolescents were divided into two groups according to the blood phenylalanine levels recommended by the European Society for Phenylketonuria by age. General characteristics of the participants, information about disease and diet were determined with a questionnaire. The Children’s Depression Inventory was used to evaluate the depression status of adolescents.

Results: While blood phenylalanine level of the girls was lower than the boys, forbidden product knowledge, consumption of low protein products and being happy living with PKU were higher. A significant negative correlation was found between dietary adherence and blood phenylalanine level in both groups blood phenylalanine levels below and above as recommended. In those with blood phenylalanine levels above the recommendation, a negative correlation was found between the level of forbidden product knowledge and blood phenylalanine. A significant positive correlation was found between blood phenylalanine levels and BMI percentiles in adolescents with poor diet control. While the relationship between the child depression scale and blood phenylalanine levels by gender was found to be insignificant, a positive correlation was found between the child depression scale and blood phenylalanine levels in the group whose blood phenylalanine levels were above the recommendations.

Conclusion: Due to difficulties encountered in social life and economic reasons adherence to diet decreases while depressive symptoms increase in adolescents with phenylketonuria. It is believed that more socio-economic support of families will increase the adherence to diet. Patients with phenylketonuria need regular meetings with dieticians and trainings to monitor the adherence to diet. Moreover child psychiatrists should be included in the treatment team to solve their mental and social problems.

Anahtar Kelimeler

• Adolescent
• Depression
• Diet
• Phenylketonuria
• Adherence

Fenilketonürili Adolesanların Diyete Uyum ve Depresif Duygu Durumu Sıklığının Saptanması

Öz

Amaç: Kan fenilalanin düzeyi ile psikolojik durum arasındaki ilişkinin ortaya konması Fenilketonüri hastaları için önemlidir. Ancak hastalığın en sık görüldüğü ülkelerden biri olan Türkiye’de Fenilketonürili adolesanlarda depresyon sıklığı ile ilgili yapılmış bir çalışma bulunmamaktadır. Bu çalışmanın amacı, Fenilketonürili adolesanlarda diyete uyum ve depresif duygu durumu sıklığının saptanmasıdır.

Gereç ve Yöntemler: Çalışma, Fenilketonürili adolesanlar ile Nisan 2019-Kasım 2019 tarihleri arasında yürütülmüştür. Adolesanlar Avrupa Fenilketonüri Birliği tarafından yaşa göre önerilen kan fenilalanin düzeylerine göre ikiye ayrılarak değerlendirilmiştir. Katılımcıların genel özellikleri, hastalık ve diyet ile ilişkili bilgiler anket formu ile belirlenmiştir. Adolesanların depresyon durumlarının değerlendirilmesinde ‘Çocuklar için Depresyon Ölçeği’ kullanılmıştır.

Bulgular: Kızların kan fenilalanin düzeyi ortalamaları erkeklerden düşük iken; yasak ürün bilgi düzeyi, düşük proteinli ürünleri sevme ve Fenilketonüri ile yaşamaktan mutlu olma puanları yüksek bulunmuştur. Kan fenilalanin düzeyi önerilene uygun olan ve olmayan gruplarda, diyete uyum ile kan fenilalanin düzeyi arasında negatif yönlü önemli ilişki saptanmıştır. Kan fenilalanin düzeyi önerilerin üzerinde olanlarda ise Fenilketonüri diyetinde yasak olan ürünleri bilme düzeyi ile kan fenilalanin arasında negatif yönlü bir ilişki bulunmuştur. Çalışmada diyet kontrolü zayıf olan adolesanlarda, kan fenilalanin düzeyleri ile beden kitle indeksi persentilleri arasında pozitif yönlü önemli ilişki saptanmıştır. Cinsiyete göre çocuk depresyon ölçeği ve kan fenilalanin düzeyleri arasındaki ilişki önemsiz bulunurken, kan fenilalanin düzeyleri önerilerin üzerinde olan grupta çocuk depresyon ölçeği ile kan fenilalanin düzeyleri arasında pozitif yönlü ilişki saptanmıştır.

Sonuç: Fenilketonürili adolesanlarda sosyal yaşamda karşılaşılan zorluklar ve ekonomik sebeplerden ötürü diyete uyum azalmakta ve depresif semptomlar artmaktadır. Ailelerin sosyoekonomik yönden daha çok desteklenmesinin diyete uyumu arttıracağına inanılmaktadır. Fenilketonürili hastaların diyete uyumlarını takip etmek ve arttırmak için düzenli diyetisyenle görüşme ve eğitimlere ihtiyaç olduğu, ayrıca ruhsal ve sosyal açıdan yaşadıkları sorunların çözümü için çocuk psikiyatristlerinin tedavi ekibinde yer almaları gerektiği düşünülmektedir.

Anahtar Kelimeler

• Adolesan
• Depresyon
• Diyet
• Fenilketonüri
• Uyum

Kaynakça

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