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González Ruiz Y, Gerk A, Stegmann J. Mental health impact on primary and secondary Prader-Willi syndrome caregivers. Child Care Health Dev 2024; 50:e13162. [PMID: 37614065 DOI: 10.1111/cch.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/05/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Caring for individuals with rare diseases can be challenging and represent a burden. Nevertheless, this has been scarcely explored in Prader-Willi syndrome (PWS). Therefore, we sought to explore the psychological impact of caregiving, as well as the differences between main caregivers and other family members. METHODS Different evaluation tools and scales were used taking into consideration the impact on caregivers. The scales were administered to those relatives who are immersed in the usual dynamics of the patient, differentiating between the main caregiver and other relatives living in the family home. RESULTS A total of 33 families of patients with genetic confirmation of PWS were included. In this survey, 32% of primary caregivers reported a high probability of anxiety, compared with 19% of non-primary caregivers (p = 0.27). Concerning depression, 40% of primary caregivers related possible or probable cases of depression compared with non-primary caregivers 13% (p = 0.04). Regarding caregiver burden evaluated using the Zarit scale, 61% of the main caregivers presented high levels of overload, compared with 29% of the other relatives (p = 0.005). Family functioning evaluated using the APGAR scale showed a total lower response from primary caregivers, but no statistically relevant results were found [25.4 ± 6.7 vs. 26.0 ± 8.2 (p = 0.72)]. CONCLUSION In this study, we observed that caring for people with PWS can have a significant effect on the mental health, burden and quality of life of caregivers, with a greater impact among primary caregivers compared with the other living relatives.
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Affiliation(s)
| | - Ayla Gerk
- Department of Clinical Medicine, SPINE Foundation, Buenos Aires, Argentina
| | - Jorgelina Stegmann
- Department of Clinical Medicine, SPINE Foundation, Buenos Aires, Argentina
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Dimitropoulos A, Doernberg EA, Russ SW, Zyga O. Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training. J Autism Dev Disord 2022; 52:5191-5206. [PMID: 35932366 PMCID: PMC9361891 DOI: 10.1007/s10803-022-05695-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.
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Affiliation(s)
| | | | | | - Olena Zyga
- Cleveland Clinic Center for Autism, Rocky River, OH, USA
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Yang-Li D, Fei-Hong L, Hui-Wen Z, Ming-Sheng M, Xiao-Ping L, Li L, Yi W, Qing Z, Yong-Hui J, Chao-Chun Z. Recommendations for the diagnosis and management of childhood Prader-Willi syndrome in China. Orphanet J Rare Dis 2022; 17:221. [PMID: 35698200 PMCID: PMC9195308 DOI: 10.1186/s13023-022-02302-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/23/2022] [Indexed: 11/28/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a complex and multisystem neurobehavioral disease, which is caused by the lack of expression of paternally inherited imprinted genes on chromosome15q11.2-q13.1. The clinical manifestations of PWS vary with age. It is characterized by severe hypotonia with poor suck and feeding difficulties in the early infancy, followed by overeating in late infancy or early childhood and progressive development of morbid obesity unless the diet is externally controlled. Compared to Western PWS patients, Chinese patients have a higher ratio of deletion type. Although some rare disease networks, including PWS Cooperation Group of Rare Diseases Branch of Chinese Pediatric Society, Zhejiang Expert Group for PWS, were established recently, misdiagnosis, missed diagnosis and inappropriate intervention were usually noted in China. Therefore, there is an urgent need for an integrated multidisciplinary approach to facilitate early diagnosis and optimize management to improve quality of life, prevent complications, and prolong life expectancy. Our purpose is to evaluate the current literature and evidences on diagnosis and management of PWS in order to provide evidence-based guidelines for this disease, specially from China.
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Affiliation(s)
- Dai Yang-Li
- Children's Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310003, China
| | - Luo Fei-Hong
- Children's Hospital of Fudan University, Shanghai, China
| | - Zhang Hui-Wen
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ma Ming-Sheng
- Peking Union Medical College Hospital, Beijing, China
| | - Luo Xiao-Ping
- Tongji Hospital, Tongji Medical College of HUST, Wuhan, China
| | - Liu Li
- Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Wang Yi
- Children's Hospital of Fudan University, Shanghai, China
| | - Zhou Qing
- Fujian Children's Hospital, Fuzhou, China
| | - Jiang Yong-Hui
- Yale University, 69 Lexington Gardens, Northern Haven, CT, 06473, USA.
| | - Zou Chao-Chun
- Children's Hospital of Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310003, China.
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Bos-Roubos A, Wingbermühle E, Biert A, de Graaff L, Egger J. Family Matters: Trauma and Quality of Life in Family Members of Individuals With Prader-Willi Syndrome. Front Psychiatry 2022; 13:897138. [PMID: 35836666 PMCID: PMC9273751 DOI: 10.3389/fpsyt.2022.897138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/02/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a potentially life threatening, genetic developmental disorder that requires lifelong medical treatment and behavioral management. PWS has a major impact on the patient's social environment. In this study, we have explored traumatic life events and symptoms of posttraumatic stress disorder (PTSD) in family members of individuals with PWS. We have also assessed quality of life in relation to trauma manifestations. In addition, we have evaluated demographic characteristics such as living setting of PWS patients as well as PWS symptom severity. METHODS Data of this observational study were obtained by means of the Life Events Checklist DMS-5, the Posttraumatic Stress Disorder Checklist DSM-5, the abbreviated World Health Organization Quality of Life questionnaire, the Lancashire Quality of Life Profile questionnaire, and a short demographic inventory. The study sample includes 98 adults aged 19 to 80 years (M = 49, SD = 15), who are relatives of 69 individuals with PWS aged 0 to 58 years (M = 19, SD = 13). Participants were recruited via the two Dutch patient associations PWS and the Dutch Digital Center of Expertise PWS. RESULTS Life time prevalence of traumatic events (93%) was higher in family members of PWS patients ("PWS relatives") than in the general Dutch population (81%). Of those who reported any traumatic event, almost half reported PWS-related events. The prevalence of probable PTSD was higher in PWS relatives (12.1%) than the general lifetime prevalence of PTSD (worldwide, and in the Netherlands 7.4%). Predominant trauma symptoms in PWS relatives were "negative changes in arousal and reactivity" and "negative changes in cognition and mood;" both significantly negatively related to quality of life. Symptom severity of PWS individuals, as well as the associated trauma symptom severity of their relatives increased with age of the PWS individual. The presence of trauma symptoms was less frequent among relatives of PWS individuals living in a care facility. CONCLUSIONS Having a relative with PWS is associated with higher prevalence of traumatic experiences and greater vulnerability to PTSD. Raising awareness in health care professionals of trauma symptoms in PWS relatives may contribute to effective treatment of their psychosocial stress. In addition, timely interventions might prevent family members from developing psychopathology like PTSD.
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Affiliation(s)
- Anja Bos-Roubos
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Ellen Wingbermühle
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Department of Human Genetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Anneloes Biert
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Laura de Graaff
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands.,Center for Adults With Rare Genetic Syndromes, Erasmus University Medical Center, Rotterdam, Netherlands.,Dutch Center of Reference for Prader-Willi Syndrome, Rotterdam, Netherlands
| | - Jos Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Department of Human Genetics, Radboud University Medical Centre, Nijmegen, Netherlands.,Stevig, Specialized and Forensic Care for People With Intellectual Disabilities, Dichterbij, Oostrum, Netherlands
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Amaro AS, Rubin DA, Teixeira MCTV, Ferreira AJ, Rodrigues GM, Carreiro LRR. Health Problems in Individuals With PWS Are Associated With Lower Quality of Life for Their Parents: A Snapshot in the Brazilian Population. Front Pediatr 2022; 10:746311. [PMID: 35242723 PMCID: PMC8885721 DOI: 10.3389/fped.2022.746311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a complex genetic disorder requiring interdisciplinary team monitoring and intensive care by parents. So far there is little information on people with PWS in Brazil. Our aim was to describe health problems and treatments used by people with PWS in Brazil and their relationship to their parents' quality of life. Parents answered questionnaires about their child's medical and exercise history, behavior problems, sociodemographic characteristics, and their own quality of life. Results: The responses of the participants showed similar health problems as in other countries. Anxiety and tantrums were the behavioral problems most commonly cited by parents. Parents of people with PWS had lower scores in respect of quality of life than the Brazilian population. Behavioral problems in individuals with PWS were negatively associated with their parents' quality of life. Behavioral and medical conditions in the children were associated with reduced quality of life in the parents. We conclude that heath care should not only be directed toward those with PWS, but also their parents.
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Affiliation(s)
- Alexandre Slowetzky Amaro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Daniela Andrea Rubin
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | | | - Arcenio José Ferreira
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Graciele Massoli Rodrigues
- Physical Education Program, Universidade São Judas Tadeu, São Paulo, Brazil.,Physical Education Program, Escola Superior de Educação Física de Jundiaí, Jundiaí, Brazil
| | - Luiz Renato Rodrigues Carreiro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
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Quality of life of parents with children with congenital abnormalities: a systematic review with meta-analysis of assessment methods and levels of quality of life. Qual Life Res 2021; 31:991-1011. [PMID: 34482484 DOI: 10.1007/s11136-021-02986-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To quantify and understand how to assess the quality of life and health-related QoL of parents with children with congenital abnormalities. METHODS We conducted a systematic review with meta-analysis. The search was carried out in 5 bibliographic databases and in ClinicalTrials.gov. No restriction on language or date of publication was applied. This was complemented by references of the studies found and studies of evidence synthesis, manual search of abstracts of relevant congresses/scientific meetings and contact with experts. We included primary studies (observational, quasi-experimental and experimental studies) on parents of children with CA reporting the outcome quality of life (primary outcome) of parents, independently of the intervention/exposure studied. RESULTS We included 75 studies (35 observational non-comparatives, 31 observational comparatives, 4 quasi-experimental and 5 experimental studies). We identified 27 different QoL instruments. The two most frequently used individual QoL instruments were WHOQOL-Bref and SF-36. Relatively to family QoL tools identified, we emphasized PedsQL FIM, IOFS and FQOL. Non-syndromic congenital heart defects were the CA most frequently studied. Through the analysis of comparative studies, we verified that parental and familial QoL were impaired in this population. CONCLUSIONS This review highlights the relevance of assessing QoL in parents with children with CA and explores the diverse QoL assessment tools described in the literature. Additionally, results indicate a knowledge gap that can help to draw new paths to future research. It is essential to assess QoL as a routine in healthcare providing and to implement strategies that improve it.
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Yang L, Ma B, Mao S, Zhou Q, Zou C. Establishing perinatal and neonatal features of Prader-Willi syndrome for efficient diagnosis and outcomes. Expert Opin Orphan Drugs 2020. [DOI: 10.1080/21678707.2020.1802718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Lili Yang
- Department of Genetics and Metabolism, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Bo Ma
- Department of Obstetrics and Gynecology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Shujiong Mao
- Division of Neonatology, Department of Pediatrics, Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiong Zhou
- Department of Endocrinology and Metabolism, Hangzhou Children’s Hospital, Hangzhou, China
| | - Chaochun Zou
- Department of Endocrinology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Oliveira-de-Souza D, Vinhaes CL, Arriaga MB, Kumar NP, Queiroz ATL, Fukutani KF, Babu S, Andrade BB. Aging increases the systemic molecular degree of inflammatory perturbation in patients with tuberculosis. Sci Rep 2020; 10:11358. [PMID: 32647178 PMCID: PMC7347549 DOI: 10.1038/s41598-020-68255-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
Tuberculosis (TB) is a chronic infection that can affect individuals of all ages. The description of determinants of immunopathogenesis in TB is of tremendous interest due to the perspective of finding a reliable host-directed therapy to reduce disease burden. The association between specific biomarker profiles related to inflammation and the diverse clinical disease presentations in TB has been extensively studied in adults. However, relatively scarce data on profiling the inflammatory responses in pediatric TB are available. Here, we employed the molecular degree of perturbation (MDP) score adapted to plasma biomarkers in two distinct databanks from studies that examined either adults or children presenting with pulmonary or extrapulmonary disease. We used multidimensional statistical analyses to characterize the impact of age on the overall changes in the systemic inflammation profiles in subpopulation of TB patients. Our findings indicate that TB results in significant increases in molecular perturbation, with the highest values being detected in adult patients. Furthermore, there were unique differences in the biomarker perturbation patterns and the overall degree of inflammation according to disease site and age. Importantly, the molecular degree of perturbation was not influenced by sex. Our results revealed that aging is an important determinant of the differences in quality and magnitude of systemic inflammatory perturbation in distinct clinical forms of TB.
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Affiliation(s)
- Deivide Oliveira-de-Souza
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, 41810-710, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, 40290-150, Brazil
| | - Caian L Vinhaes
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, 41810-710, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, 40290-150, Brazil
| | - María B Arriaga
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, 41810-710, Brazil
| | - Nathella Pavan Kumar
- International Center for Excellence in Research, National Institutes of Health- National Institute for Research in Tuberculosis, Chennai, 600031, India
| | - Artur T L Queiroz
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, 41810-710, Brazil
| | - Kiyoshi F Fukutani
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, 40296-710, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, 41810-710, Brazil
- Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, 40290-150, Brazil
| | - Subash Babu
- International Center for Excellence in Research, National Institutes of Health- National Institute for Research in Tuberculosis, Chennai, 600031, India
- Laboratory of Parasitic Diseases, NIAID, NIH, Bethesda, 20892, USA
| | - Bruno B Andrade
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, 40296-710, Brazil.
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, 41810-710, Brazil.
- Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, 40290-150, Brazil.
- Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, 40290-000, Brazil.
- Laureate Universities, Universidade Salvador (UNIFACS), Salvador, 41720-200, Brazil.
- Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7925, South Africa.
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