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Ebeid FSE, Mokhtar GM, Zaky EA, Abdelmageed RI, Elkamel NM, Ali HGA. Psychosocial and mental profile of children with sickle cell disease and their caregivers. Pediatr Hematol Oncol 2024; 41:15-29. [PMID: 37773584 DOI: 10.1080/08880018.2023.2261975] [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: 04/27/2023] [Accepted: 08/22/2023] [Indexed: 10/01/2023]
Abstract
Sickle cell disease (SCD), a chronic debilitating disorder that may negatively affect health-related quality-of-life (HRQoL). In this observational, case-control study, we aim to assess the prevalence of impaired psychosocial profile and poor HRQoL among SCD patients and their caregivers as well as to determine the association of such impairment with parameters of disease severity. Sixty-five children and adolescents with SCD and 65 age- and sex-matched healthy controls and their caregivers were recruited. Demographic and clinical characteristics were collected, and a thorough clinical and psychiatric assessments and HR QoL were conducted. Recruited children and adolescents with SCD were 34 (52.3%) boys and 31 (47.7%) girls, and their mean age was 11.40 ± 3.55. Most of them (n = 44, 67.7%) had sickle HbSβ+, and vaso-occlusive crises were the most common causes for hospital admission (n = 24, 36.9%). Children with SCD and their caregivers had depression and anxiety symptoms scores higher than reported in the control group. Children with SCD had significantly less self-esteem and less QoL scores with the least scores were in the communication domain. This adverse psychological profile was significantly negatively correlated with the age of the child, duration of illness, number and duration of hospitalizations, disease severity score, and occurrence of complications. We conclude that HRQoL of children suffering from SCD, and their caregivers are adversely affected necessitating implementation of interventions which focus on reducing depressive symptoms, enhancing self-esteem and QoL.
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Affiliation(s)
- Fatma S E Ebeid
- Department of Pediatric Haematology Oncology and BMT, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Galila Mohamed Mokhtar
- Department of Pediatric Haematology Oncology and BMT, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman Ahmed Zaky
- Department of Paediatric Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Nermeen Mohamed Elkamel
- Department of Pediatric Haematology Oncology and BMT, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba G A Ali
- Department of Pediatric Haematology Oncology and BMT, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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2
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Sidhu GS, Garg K, Chopra V. Stigma and self-esteem in patients of bronchial asthma. Monaldi Arch Chest Dis 2023. [PMID: 37817740 DOI: 10.4081/monaldi.2023.2711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023] Open
Abstract
Asthma is a debilitating chronic disease that renders individuals physically as well as mentally sick. The perception of stigmatization further leads to inappropriate control of asthma resulting in a bidirectional relationship. A prospective, cross-sectional study was conducted in a tertiary care centre of semi urban area of north India during 2021-2022. Three hundred cases of bronchial asthma and 50 healthy controls were enrolled. The asthma control test (ACT) was used to evaluate the control of asthma. Stigma and self-esteem were measured with the use of 28 item self-stigma scale, Rosenberg self-esteem scale, and stigma-related social problem scale (SPSS). The impact of sociodemographic and clinical profiles on stigma and self-esteem was evaluated. Correlation of different scales with each other was done along with. The mean age of asthmatic patients was 47.41±15.507 years with 56% being females; 49.3% of patients were well controlled and 36.3% were partly controlled. Positive subscales of 28 item self-stigma scale, Rosenberg self-esteem scale and SSPS showed statistically significant differences between cases and controls (p<0.001). ACT significantly correlated with 28 item self-stigma scale, Rosenberg self-esteem scale and SSPS, and all three stigma and self-esteem scales correlated significantly with each other.
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Affiliation(s)
| | - Kranti Garg
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab.
| | - Vishal Chopra
- Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab.
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Barth Syndrome: Psychosocial Impact and Quality of Life Assessment. J Cardiovasc Dev Dis 2022; 9:jcdd9120448. [PMID: 36547445 PMCID: PMC9784194 DOI: 10.3390/jcdd9120448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Barth syndrome (BTHS) is a rare X-linked genetic disease that affects multiple systems and leads to complex clinical manifestations. Although a considerable amount of research has focused on the physical aspects of the disease, less has focused on the psychosocial impact and quality of life (QoL) in BTHS. METHODS The current study investigated caregiver- (n = 10) and self-reported (n = 16) psychological well-being and QoL in a cohort of BTHS-affected patients and families. Participants completed the depression and anxiety components of the Patient-Reported Outcomes Information System (PROMIS) Short Form 8A and Health-related quality of life (HRQoL) surveys at enrollment and again during a follow-up period ranging from 6 to 36 months after baseline. RESULTS Quality of life changed significantly over time and the various domains with some improvement and some decline. Among the available caregiver-patient dyad data, there was a trend toward discordance between caregiver and self-reported outcomes. Most notably, patients reported improvement in HRQoL, while caregivers reported declines. This suggests that there may be differences in perceived quality of life between the patients and parents, though our study is limited by small sample size. CONCLUSION Our study provides valuable insights into the impacts of psychosocial and mental health aspects of BTHS. Implications of these findings include incorporating longitudinal assessment of QoL and screening for psychological symptoms in BTHS care to identify interventions that may drastically impact health status and the course of the disease.
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Scarponi D, Cangini G, Pasini A, La Scola C, Mencarelli F, Bertulli C, Amabile D, Busutti M, La Manna G, Pession A. The process of transition from pediatric to adult healthcare services for nephrological patients: Recommendations vs. reality-A single center experience. Front Pediatr 2022; 10:954641. [PMID: 36081623 PMCID: PMC9445415 DOI: 10.3389/fped.2022.954641] [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: 05/27/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Transitional care is an essential step for patients with kidney disease, and it is supported by policy documents in the United Kingdom and United States. We have previously described the heterogeneous situation currently found in Europe regarding certain aspects of transitional care: the written transition plan, the educational program, the timing of transfer to adult services, the presence of a coordinator and a dedicated off-site transition clinic. In line with the transition protocol "RISE to transition," the objective of this paper is to describe the experience of the Bologna center in defining a protocol for the management of chronic kidney disease and the difficulties encountered in implementing it. We apply this model to various chronic diseases along the process of transfer to adult services. It begins when the patient is 14 years old and is complete by the time they reach 18. The family is continuously involved and all the patients in transitional care receive continuous medical care and psychological support. We identified a series of tests designed to measure various criteria: medical condition, psychological state, quality of life, and degree of patient satisfaction, which are repeated at set intervals during the transition process. The organization of the service provided an adequate setting for taking charge of the patients in the long term. The transition program implemented by the adult and pediatric nephrology services of the Bologna center has lowered the risk of discontinuity of care and greatly improved the patients' awareness of responsibility for their own healthy lifestyle choices.
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Affiliation(s)
- Dorella Scarponi
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gabriella Cangini
- Department of Specialist, Diagnostic and Experimental Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Andrea Pasini
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claudio La Scola
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Mencarelli
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Cristina Bertulli
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Domenico Amabile
- Specialty School of Pediatrics, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Marco Busutti
- Nephrology, Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gaetano La Manna
- Nephrology, Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Pession
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Robertson AO, Tadić V, Rahi JS. This is me: A qualitative investigation of young people's experience of growing up with visual impairment. PLoS One 2021; 16:e0254009. [PMID: 34234377 PMCID: PMC8263264 DOI: 10.1371/journal.pone.0254009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Childhood visual impairment (VI) has a profound impact on many aspects of childhood and adolescence. This is well-documented in cross-sectional and/or quantitative studies utilizing self-report instruments which compare children with and without VI. Young people's views on the experience of growing up with VI as a developmental, change-driven process remain largely unexplored. METHODS As part of our broader research programme on quality of life of visually impaired children and young people in the United Kingdom, in-depth, semi-structured interviews were conducted between March and June 2015, with a stratified sample of 17 young people with VI, aged 16-19 years. An age-sensitive, empirically-based topic guide encouraged retrospective reflections on participants' experiences of growing up with VI, including age-normative and vision-specific challenges. RESULTS Descriptions of growing up with VI largely centered on an overarching higher-order theme labelled becoming me. Four themes representing everyday activities, attitudes, preferences and perceptions in relation to i) social relationships, ii) independence and responsibilities, iii) the future, and iv) rising to challenges emerged and were used by participants in their description of three stages in which they developed a sense of self: i) laying the foundations, ii) testing the waters, and iii) this is me. Differences in manifestation of VI influenced how young people made sense of their experiences and their sense of self. CONCLUSIONS Findings are discussed in relation to normative and vision-specific changes in psychosocial development during adolescence, including the development of identity. They highlight the need for ongoing monitoring of subjective well-being in a clinical population with a unique early life course trajectory.
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Affiliation(s)
- Alexandra O. Robertson
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Valerija Tadić
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jugnoo S. Rahi
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
- Ulverscroft Vision Research Group, London, United Kingdom
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Zheng K, George M, Roehlkepartain E, Santelli J, Bruzzese JM, Smaldone A. Developmental Assets of Adolescents and Young Adults With Chronic Illness and Comorbid Depression: Qualitative Study Using YouTube. JMIR Ment Health 2021; 8:e23960. [PMID: 33591288 PMCID: PMC7925153 DOI: 10.2196/23960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/20/2020] [Accepted: 12/19/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Developmental assets provide a framework for optimizing development among adolescents but have not been studied in adolescents with chronic illness and comorbid depression, which is a group at risk for poor health outcomes. YouTube postings provide valuable insights to understand this understudied population. OBJECTIVE This study aims to explore asset development from the perspectives of adolescents and young adults (AYAs) with chronic illness and comorbid depression. METHODS YouTube was searched using 12 chronic illnesses (eg, diabetes) coupled with "depression" as keywords. Videos were included if they were uploaded by AYAs aged between 11 and 29 years and discussed living with chronic illness and depression during adolescence. Video transcripts were coded deductively for 40 internal and external assets that constitute the Developmental Assets Framework. Categories not captured by deductive coding were identified using conventional content analysis. Categories and their respective assets were labeled as being discussed either negatively or positively. RESULTS In total, 31 videos from 16 AYAs met the inclusion criteria. A total of 7 asset categories, support, constructive use of time, boundaries and expectations (external assets), identity, commitment to learning, positive values, and social competence (internal assets), reflecting 25 (13 internal; 12 external) assets, were discussed. Internal assets, particularly relating to identity, were commonly discussed by AYAs either in a negative way or fluctuated between positive and negative perspectives. CONCLUSIONS In this sample of AYAs with chronic illness and comorbid depression, internal assets were commonly discussed in a negative way. Future research is needed to better understand how assets develop and if the Developmental Assets Framework adequately represents the experiences of this population.
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Affiliation(s)
- Katherine Zheng
- The Feinberg School of Medicine, Center for Education in Health Sciences, Northwestern University, Chicago, IL, United States.,Columbia University School of Nursing, New York, NY, United States
| | - Maureen George
- Columbia University School of Nursing, New York, NY, United States
| | | | - John Santelli
- Columbia University Mailman School of Public Health, New York, NY, United States
| | | | - Arlene Smaldone
- Columbia University School of Nursing, New York, NY, United States
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Savran O, Godtfredsen NS, Sørensen T, Jensen C, Ulrik CS. Comparison of Characteristics Between ICS-Treated COPD Patients and ICS-Treated COPD Patients with Concomitant Asthma: A Study in Primary Care. Int J Chron Obstruct Pulmon Dis 2020; 15:931-937. [PMID: 32425518 PMCID: PMC7196437 DOI: 10.2147/copd.s241561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/21/2020] [Indexed: 11/23/2022] Open
Abstract
Background and Objective Inhaled corticosteroids (ICS) for COPD has been much debated. Our aim was to identify characteristics associated with prescribing ICS for patients with COPD alone compared to those with concomitant asthma in general practice. Patients and Methods Participating general practitioners (GPs) (n=144) recruited patients with COPD (ICPC 2nd ed. code R95) currently prescribed ICS (ACT code R03AK and R03BA). Data, if available, on demographics, smoking habits, spirometry, COPD medication, dyspnea score, and exacerbation history were retrieved from the medical records. Logistic regression analysis was used to identify possible differences in characteristics between patients with COPD alone compared to those having a concomitant diagnosis of asthma. Results A total of 2.289 (45% males) COPD patients on ICS were recruited. Compared to patients with COPD alone (n=1.749), those with COPD and concomitant asthma (n=540) were younger (p<0.001), had higher BMI, higher FEV1/FVC ratio, higher blood eosinophil count and less life-time tobacco exposure (36 and 26 pack-years, respectively). Compared to COPD alone, logistic regression analysis showed that COPD with concomitant asthma was significantly associated to age (OR 0.94; CI 0.92 to 0.97; p<0.001), pack-years of smoking (OR 0.98; CI 0.97 to 0.99; p<0.001), %pred (OR 1.02; CI 1.00 to 1.03; p=0.005), and doctor-diagnosed depression (OR 2.59; CI 1.20 to 5.58; p=0.015). Conclusion In COPD patients currently prescribed ICS, the presence of concomitant asthma was associated with being younger, having less tobacco exposure, more preserved lung function and a higher likelihood of doctor-diagnosed depression compared to COPD alone.
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Affiliation(s)
- Osman Savran
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
| | - Nina Skavlan Godtfredsen
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen,Denmark
| | | | | | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen,Denmark
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Kogon AJ, Kim JY, Laney N, Radcliffe J, Hooper SR, Furth SL, Hartung EA. Depression and neurocognitive dysfunction in pediatric and young adult chronic kidney disease. Pediatr Nephrol 2019; 34:1575-1582. [PMID: 31049719 DOI: 10.1007/s00467-019-04265-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/20/2019] [Accepted: 04/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Depression affects 7-35% of children with chronic kidney disease (CKD), and in adults with CKD, the presence of depression links to poorer medical outcomes, social functioning difficulties, and neurocognitive impairments. The relationship between depression and neurocognitive function in youth with CKD is unclear. We sought to identify factors associated with depression in youth with CKD and to determine whether depression affects neurocognitive performance. METHODS We conducted cross-sectional analyses in 71 CKD and 64 control participants aged 8 to 25 years who completed depression inventories and neurocognitive assessments as part of the Neurocognitive Assessment and Magnetic Resonance Imaging Analysis of Children and Young Adults with CKD Study. In the CKD group, multivariable logistic regression analysis determined associations between clinical and demographic factors and depression. In the full study cohort, multivariable linear regression analyses, including an interaction term between CKD status and depression evaluated the effect of depression on 11 neurocognitive outcome domains. RESULTS Obesity significantly associated with depression in the CKD group (OR 10.25, P = 0.01). In adjusted analyses, depressed youth with CKD scored worse than non-depressed CKD participants by 0.6-1.0 standard deviations in 5 neurocognitive domains: attention, visual memory, visual-spatial, visual working memory, and problem solving. CONCLUSIONS CKD youth with obesity are more likely to be depressed, and those who are depressed exhibit worse neurocognitive performance. Depression may represent a therapeutic target to improve neurocognitive performance in youth with CKD.
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Affiliation(s)
- Amy J Kogon
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19103, USA. .,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Ji Young Kim
- Biostatistics Core, the Center for Human Phenomic Science, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Nina Laney
- Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jerilynn Radcliffe
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stephen R Hooper
- Department of Allied Health Sciences, School of Medicine University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Susan L Furth
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19103, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Erum A Hartung
- Division of Nephrology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19103, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Huurre T, Aro H. The Psychosocial Weil-Being of Finnish Adolescents with Visual Impairments versus those with Chronic Conditions and those with no Disabilities. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x0009401003] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Taina Huurre
- Tampere School of Public Health, University of Tampere, and National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, FIN-00300 Helsinki, Finland
| | - Hillevi Aro
- Tampere School of Public Health, University of Tampere, and National Public Health Institute, Department of Mental Health and Alcohol Research
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Henry MB, Bakeera-Kitaka S, Lubega K, Snyder SA, LaRussa P, Pfeffer B. Depressive symptoms, sexual activity, and substance use among adolescents in Kampala, Uganda. Afr Health Sci 2019; 19:1888-1896. [PMID: 31656472 PMCID: PMC6794506 DOI: 10.4314/ahs.v19i2.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Adolescents experience high rates of depression, initiation of sexual activity, and substance use. OBJECTIVES To better understand the demographics of adolescents presenting to an adolescent clinic in Uganda, and to elucidate which factors are associated with depressive symptoms, sexual initiation, and substance use. METHODS A retrospective review was performed on intake forms obtained during interviews with adolescents presenting to the Makerere/Mulago Columbia Adolescent Health Clinic (MMCAH) in Kampala, Uganda. RESULTS Depressive symptoms in adolescents were correlated with having a chronic illness (p=.026), and reported poor quality of home life (p<.001). Initiation of sexual activity was also correlated with chronic illness (p=.008) and poor quality of home life (p=.006). Substance use was correlated with maternal death (p=.041), chronic illness (p=.038), and substance use among family members (p<.001) and friends (p<.001). CONCLUSIONS Knowing the aforementioned risk factors can help us better understand the needs of adolescents presenting to MMCAH, and allows us to develop targeted interventions aimed at decreasing health risks in Kampala's adolescent population.
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Affiliation(s)
- Michael B Henry
- Columbia University, Department of Pediatrics, College of Physicians and Surgeons, New York, USA
| | - Sabrina Bakeera-Kitaka
- Makerere University College of Health Sciences, Department of Paediatrics and Child health, Kampala, Uganda
- Mulago Hospital, Makerere/Mulago Columbia Adolescent Health Clinic (MMCAH), Kampala, Uganda
| | - Kizza Lubega
- Mulago Hospital, Makerere/Mulago Columbia Adolescent Health Clinic (MMCAH), Kampala, Uganda
| | - Sara A Snyder
- Columbia University, Mailman School of Public Health, New York, USA
- Long Island University, Department of Clinical Psychology, New York, USA
| | - Philip LaRussa
- Columbia University, Department of Pediatrics, College of Physicians and Surgeons, New York, USA
| | - Betsy Pfeffer
- Columbia University, Department of Pediatrics, College of Physicians and Surgeons, New York, USA
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Reinauer C, Viermann R, Förtsch K, Linderskamp H, Warschburger P, Holl RW, Staab D, Minden K, Muche R, Domhardt M, Baumeister H, Meissner T. Motivational Interviewing as a tool to enhance access to mental health treatment in adolescents with chronic medical conditions and need for psychological support (COACH-MI): study protocol for a clusterrandomised controlled trial. Trials 2018; 19:629. [PMID: 30428891 PMCID: PMC6236943 DOI: 10.1186/s13063-018-2997-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 10/16/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents' utilisation of psychological health care for symptoms of anxiety or depression. METHODS/DESIGN In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session. DISCUSSION This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents' long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood. TRIAL REGISTRATION German Trials Register (DRKS), DRKS00014043 . Registered on 26 April 2018. Düsseldorf University study ID: 2017114504.
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Affiliation(s)
- Christina Reinauer
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children’s Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225 Germany
| | - Rabea Viermann
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children’s Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225 Germany
| | - Katharina Förtsch
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children’s Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225 Germany
| | - Hannah Linderskamp
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children’s Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225 Germany
| | | | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Doris Staab
- Division of Pulmonology and Immunology, Department of Paediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Berlin, Germany
| | - Kirsten Minden
- German Rheumatism Research Centre Berlin, Leibniz Institute, Berlin, Germany
- Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany
| | - Rainer Muche
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Matthias Domhardt
- Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - Harald Baumeister
- Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
| | - Thomas Meissner
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children’s Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225 Germany
| | - COACH consortium
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children’s Hospital, Medical Faculty, Moorenstr. 5, Düsseldorf, 40225 Germany
- Department of Psychology, University of Potsdam, Potsdam, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- Division of Pulmonology and Immunology, Department of Paediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Berlin, Germany
- German Rheumatism Research Centre Berlin, Leibniz Institute, Berlin, Germany
- Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
- Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
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Rebane K, Ristolainen L, Relas H, Orenius T, Kautiainen H, Luosujärvi R, Aalto K, Säilä H. Disability and health-related quality of life are associated with restricted social participation in young adults with juvenile idiopathic arthritis. Scand J Rheumatol 2018; 48:105-113. [PMID: 30270708 DOI: 10.1080/03009742.2018.1493140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To describe a cohort of Finnish juvenile idiopathic arthritis (JIA) patients, to recognize those young adults who are at risk of becoming socially restricted by their long-term rheumatic disease, and to assess which areas of self-rated health-related quality of life (HRQoL) are associated with the emergence of restricted social participation. METHODS A total of 195 young adults with JIA completed questionnaires addressing demographics, health behaviour, physical activity, functional ability, HRQoL, depressive symptoms, and self-esteem. Patients were classified as having non-restricted social participation if they were engaged in studying, working, maternity leave, or military service, and restricted social participation if they were unemployed or on disability pension. RESULTS Of the patients, 162 (83%) were considered as having non-restricted social participation and 33 (16%) restricted social participation. Among patients with restricted social participation, five (15%) were on disability pension and 28 (85%) were unemployed. Patients with restricted social participation participated less in leisure-time non-physical activities (p = 0.033), felt more disturbed during their leisure time (p = 0.010), had lower self-esteem (p = 0.005), and had higher disability scores (p = 0.024). HRQoL scores revealed statistically significant differences between the groups: physical functioning (p = 0.043), social functioning (p = 0.016), and emotional well-being (p = 0.049) were all lower in patients with restricted social participation. CONCLUSIONS Socially restricted patients showed a higher degree of disability, and lower levels of physical functioning, self-esteem, emotional well-being, and social functioning. These patients should be recognized earlier and interventions provided to enhance their social participation.
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Affiliation(s)
- K Rebane
- a Children's Hospital , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - L Ristolainen
- b Research Institute Orton , Orton, Helsinki , Finland
| | - H Relas
- c Department of Medicine, Division of Rheumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - T Orenius
- d Orton Orthopaedic Hospital , Orton, Helsinki , Finland
| | - H Kautiainen
- e Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - R Luosujärvi
- c Department of Medicine, Division of Rheumatology , Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland
| | - K Aalto
- a Children's Hospital , University of Helsinki and Helsinki University Central Hospital , Helsinki , Finland
| | - H Säilä
- d Orton Orthopaedic Hospital , Orton, Helsinki , Finland
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Obesity, diet and lifestyle in 9-year-old children with parentally reported chronic diseases: findings from the Growing Up in Ireland longitudinal child cohort study. Ir J Med Sci 2018; 188:29-34. [PMID: 29728820 DOI: 10.1007/s11845-018-1814-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 04/10/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The incidence and prevalence of childhood chronic disease is increasing worldwide. Obesity, poor diet and lifestyle may be more prevalent in children with a chronic disease than in their healthier contemporaries. The Growing Up in Ireland (GUI) study is a nationally representative cohort study of children living in the Republic of Ireland. The study has collected information from 8568 9-year-old Irish children on their experiences within their families, childcare settings, schools and communities, and how these impact on all aspects of children's development. AIMS This study aims to establish the prevalence of parentally reported chronic disease in children in Ireland and to describe their diet and lifestyle. METHODS This study analyzed data from the Growing Up in Ireland longitudinal child cohort study and compared the diet, lifestyle and prevalence of obesity in children with and without a parentally reported chronic disease. RESULTS Overall, 954 parents in the sample (11.1%) reported that their child had a chronic illness and 43.4% of these children are hampered by it in their daily activities. Respiratory disorders were the commonest type of chronic disease (46%) reported. Children with a chronic illness were more likely to be overweight or obese (32.9% compared to 25.0% of those without a chronic illness, p < 0.001). Children with chronic illness were also found to have a poorer diet, take less exercise and experienced significantly more social isolation than their peers (all p < 0.05). CONCLUSIONS Public health measures to address diet and lifestyle choices need to be cognisant of the needs of children with chronic diseases and tailor activities offered to be inclusive of all children. Medical professionals having contact with children with chronic conditions need to remember to reinforce the importance of diet and lifestyle whenever possible and to explore with families solutions to barriers to making healthy diet and lifestyle choices.
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Danel DP, Siennicka AE, Fedurek P, Frackowiak T, Sorokowski P, Jankowska EA, Pawlowski B. Men With a Terminal Illness Relax Their Criteria for Facial Attractiveness. Am J Mens Health 2017. [PMID: 28625113 PMCID: PMC5675349 DOI: 10.1177/1557988317692504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
According to the life history paradigm, in life-threatening conditions, sexual selection criteria are relaxed in order to increase the probability of a last resort reproduction, ultimately contributing to reproductive success. This should be reflected in loosened mating preferences — a process observed in nonhuman animals. Studies investigating this aspect in humans, however, are scarce. This study explored the aesthetic preferences towards facial and nonfacial stimuli in terminally ill patients with heart failure (HF) and their healthy, same-sex peers. The aim was to examine if these two groups of men demonstrate different patterns of aesthetic judgments. Using a 7-point scale, 65 male patients with HF and 143 healthy men evaluated the perceived attractiveness of 15 photographs (five adult male faces, five adult female faces, and five nonfacial pictures). A mixed-design analysis of variance was run to assess group differences in aesthetic preferences. Compared to healthy controls, stimuli. HF patients rated the pictures using significantly higher scores, but this applied only to male and female, but not nonfacial, stimuli. We propose that lower criteria for facial attractiveness in HF patients are linked to relaxation of mate preferences as a result of a life-threatening conditions, and that this process can be an adaptive mating strategy from an ultimate, evolutionary perspective. However, other mechanisms (e.g., seeking social support) may be also responsible for the observed patterns.
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Affiliation(s)
- Dariusz P Danel
- 1 Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, PAS, Wrocław, Poland
| | - Agnieszka E Siennicka
- 2 Wrocław Medical University, Wrocław, Poland.,3 Clinical Military Hospital, Wrocław, Poland
| | - Pawel Fedurek
- 4 Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | | | | | - Ewa A Jankowska
- 1 Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, PAS, Wrocław, Poland.,2 Wrocław Medical University, Wrocław, Poland.,3 Clinical Military Hospital, Wrocław, Poland
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Husarova D, Geckova AM, Blinka L, Sevcikova A, van Dijk JP, Reijneveld SA. Screen-based behaviour in school-aged children with long-term illness. BMC Public Health 2016; 16:130. [PMID: 26861123 PMCID: PMC4746885 DOI: 10.1186/s12889-016-2804-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/01/2016] [Indexed: 11/30/2022] Open
Abstract
Background Evidence is lacking on the screen-based behaviour of adolescents with a chronic condition. The aim of our study was to analyse differences in screen-based behaviour of adolescents by long-term illness, asthma and learning disabilities. Methods We used data from the cross-sectional Health Behaviour of School-aged Children study collected in 2014 among Slovak adolescents (age 13 to 15 years old, N = 2682, 49.7 % boys). We analysed the associations between screen-based behaviour and long-term illness, asthma and learning disabilities using logistic regression models adjusted for gender. Results We found no associations between screen-based behaviour and long-term illness, except that children with asthma had a 1.60-times higher odds of excessively playing computer games than healthy children (95 % confidence interval of odds ratio (CI): 1.11–2.30). Children with learning disabilities had 1.71-times higher odds of risky use of the Internet (95 % CI: 1.19–2.45). Conclusion Adolescents with a long-term illness or with a chronic condition or a learning disability do not differ from their peers in screen-based activities. Exceptions are children with asthma and children with learning disabilities, who reported more risky screen-based behaviour.
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Affiliation(s)
- Daniela Husarova
- Department of Health Psychology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic.
| | - Andrea Madarasova Geckova
- Department of Health Psychology, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Center for Kinanthropology Research, Institute of Active Lifestyle, Faculty of Physical Culture, Palacky University in Olomouc, Tr. Miru 115, Olomouc, 77111, Czech Republic. .,Olomouc University Social Health Institute, Palacky University Olomouc, Tr. Miru 115, Olomouc, 77111, Czech Republic.
| | - Lukas Blinka
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University Brno, Joštova 10, 602 00, Brno, Czech Republic.
| | - Anna Sevcikova
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University Brno, Joštova 10, 602 00, Brno, Czech Republic.
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, Kosice, 040 01, Slovak Republic. .,Olomouc University Social Health Institute, Palacky University Olomouc, Tr. Miru 115, Olomouc, 77111, Czech Republic. .,Department of Community & Occupational Health, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Community & Occupational Health, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
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Kensbock JM, Boehm SA. The role of transformational leadership in the mental health and job performance of employees with disabilities. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2015. [DOI: 10.1080/09585192.2015.1079231] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sehlo MG, Kamfar HZ. Depression and quality of life in children with sickle cell disease: the effect of social support. BMC Psychiatry 2015; 15:78. [PMID: 25880537 PMCID: PMC4394397 DOI: 10.1186/s12888-015-0461-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 03/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The majority of available studies have shown that children with sickle cell disease (SCD) have a higher risk of depressive symptoms than those without. The present study aimed to: assess the prevalence of depression in a sample of children with SCD; evaluate the association between disease severity, social support and depression, and the combined and/or singular effect on health-related quality of life (HRQL) in children with SCD; and show the predictive value of social support and disease severity on depression. METHODS A total of 120 children were included in the study, 60 (group I) with SCD and 60 matched, healthy control children (group II). Depression was assessed in both groups using the Children's Depression Inventory (CDI) and the Children's Depression Inventory-Parent (CDI-P). Children with CDI and CDI-P scores of more than 12 were interviewed for further assessment of depression using the Diagnostic Interview Schedule for Children Version IV (DISC-IV). The Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) was used to assess HRQL in both groups, and social support was measured with the Child and Adolescent Social Support Scale (CASSS). RESULTS Eight (13%) of the 60 children with SCD had CDI and CDI-P scores of more than 12 (CDI mean score 14.50 ± 1.19, CDI-P mean score 14.13 ± 1.12), and were diagnosed as having clinical depression using the diagnostic interview DISC-IV. For group I, HRQL was poor across all PedsQL 4.0 domains in both self- and parent-reports (P < 0.001) compared with group II. A higher level of parent support was a significantly associated with decreased depressive symptoms, demonstrated by lower CDI scores. Better quality of life was shown by the associated higher total PedsQL 4.0 self-scores of children with SCD (B = -1.79, P = 0.01 and B = 1.89, P = 0.02 respectively). CONCLUSIONS The present study demonstrates that higher levels of parent support were significantly associated with decreased depressive symptoms and better quality of life in children with SCD. Interventions focused on increasing parent support may be an important part of treatment for depression in children with SCD.
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Affiliation(s)
- Mohammad Gamal Sehlo
- Department of Medicine, Psychiatry Unit, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, P. O. Box 80205, Jeddah, Kingdom of Saudi Arabia.
- Department of Psychiatry, Zagazig University, Zagazig, Egypt.
| | - Hayat Zakaria Kamfar
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Letitre SL, de Groot EP, Draaisma E, Brand PLP. Anxiety, depression and self-esteem in children with well-controlled asthma: case-control study. Arch Dis Child 2014; 99:744-8. [PMID: 24812302 DOI: 10.1136/archdischild-2013-305396] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Although asthma has been linked to psychological morbidity, this relationship may be confounded by poor asthma control. We aimed to compare the prevalence of anxiety, depression and low level of self-esteem in children with well-controlled asthma with that of healthy peers. SETTING Dedicated asthma clinic in a general hospital. PATIENTS 70 patients with mostly well-controlled asthma and 70 matched healthy controls. INTERVENTIONS Comprehensive asthma education, management and follow-up for asthma patients. MAIN OUTCOME MEASURES Validated Dutch versions of the Childhood Depression inventory (CDI), Revised Fear Survey for Children (RFSC), Self Perception Profile for Children (SPC-C) and Adolescents (SPC-A) and State-Trait Anxiety Inventory for Children (STAIC). Asthma control assessed by asthma control questionnaire. RESULTS No significant differences were found in total scores between asthmatics and controls (95% CI for difference -0.2 to 2.9 for CDI, -5.9 to 11.2 for RFSC, -19.9 to 6.3 for SPC-C, -24.1 to 5.0 for SPC-A and -2.7 to 0.01 for STAIC). There were also no significant differences between asthmatics and controls in the prevalence of scores exceeding cut-off levels for clinically relevant anxiety (13.3 vs 13.0%, p=0.605), depression (12.9 vs 5.7%, p=0.243) or low self-esteem (21.4 vs 12.9%, p=0.175). A significant correlation was found between poorer asthma control and CDI (p=0.012) and anxiety trait symptoms (p<0.001). CONCLUSIONS Children with well-controlled asthma enrolled in a comprehensive asthma management programme do not have an increased risk of anxiety, depression and poor self-esteem. Earlier reports of psychological comorbidity in asthma may have been related to inadequately controlled asthma.
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Affiliation(s)
- Sarah L Letitre
- Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands
| | - Eric P de Groot
- Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands
| | - Eelco Draaisma
- Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands
| | - Paul L P Brand
- Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands
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Overlapping biological mechanisms underlying sickle cell disease, stress, and depression: a stress-vulnerability framework. Harv Rev Psychiatry 2014; 22:205-15. [PMID: 24887328 DOI: 10.1097/hrp.0000000000000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After participating in this activity, learners should be better able to:1. Evaluate the overlap between sickle cell disease (SCD) and depression.2. Identify sources of psychological stress and biological vulnerabilities toward developing depression in patients with SCD.3. Assess the potential mechanisms underlying SCD, stress, and depression.Depression is a common co-occurring disorder in persons with sickle-cell disease (SCD). Individuals with this chronic illness may be particularly vulnerable to depression. In addition to risk factors for depression specifically related to SCD, these individuals typically experience further psychological stress due to multiple risk factors in their environment. To date, however, little research has focused on the co-occurring biological mechanisms across these conditions and how those mechanisms may interact to produce depressive symptoms. In this review we use a stress-vulnerability framework to describe the sources of psychological stress and the SCD factors that increase the risk of depression. We suggest that several biological factors, such as nitric oxide and cytokines, may play an important role in co-occurring stress, SCD, and depression. The interaction of these factors may be of particular importance for understanding the comorbidity of SCD and depression. Implications for current treatment and future research are discussed.
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Rassart J, Luyckx K, Moons P, Weets I. Personality and self-esteem in emerging adults with Type 1 diabetes. J Psychosom Res 2014; 76:139-45. [PMID: 24439690 DOI: 10.1016/j.jpsychores.2013.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 11/21/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The present study examined (1) mean-level differences in self-esteem and Big Five personality traits between individuals with and without diabetes; and (2) demographic, clinical, and psychological correlates of patients' self-esteem and Big Five. RESEARCH DESIGN AND METHODS A total of 478 emerging adults with Type 1 diabetes (18-35 years old) were selected from the Belgian Diabetes Registry and completed questionnaires on personality, self-esteem, and diabetes-related distress. The control group consisted of 341 healthy participants who were matched (1:1) on sex and age with the patient group. RESULTS First, mean-level differences between patients and controls differed according to patients' sex and illness duration. Women with diabetes reported lower self-esteem and were less extraverted and emotionally stable as compared to female controls. In contrast, men with diabetes reported higher self-esteem and were more agreeable but less emotionally stable as compared to male controls. Furthermore, whereas both patients with shorter and longer illness duration were less extraverted and emotionally stable as compared to controls, only patients with longer illness duration reported heightened agreeableness. Second, self-esteem and Big Five were found to relate to patients' sex and (to a lesser extent) age and illness duration. Finally, patients reporting elevated diabetes-related distress reported lower self-esteem, and were less agreeable and emotionally stable as compared to patients not reporting such distress. CONCLUSIONS Patients' personality and self-esteem might be important targets for future prevention and intervention efforts. The present findings can assist healthcare professionals in identifying those patients who might benefit the most from such programs.
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Affiliation(s)
| | | | - Philip Moons
- KU Leuven, Leuven, Belgium; University Hospitals of Leuven, Leuven, Belgium; The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ilse Weets
- Free University Brussels, Brussels, Belgium
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Ferro MA, Boyle MH. Brief report: Testing measurement invariance and differences in self-concept between adolescents with and without physical illness or developmental disability. J Adolesc 2013; 36:947-51. [DOI: 10.1016/j.adolescence.2013.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/11/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
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Kogon AJ, Stoep AV, Weiss NS, Smith J, Flynn JT, McCauley E. Depression and its associated factors in pediatric chronic kidney disease. Pediatr Nephrol 2013; 28:1855-61. [PMID: 23700174 PMCID: PMC3897296 DOI: 10.1007/s00467-013-2497-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Few studies on the occurrence of depression in pediatric patients with chronic kidney disease (CKD) have been conducted and none have identified associated clinical and demographic factors. METHODS This was a cross-sectional study in which we administered the Child Depression Inventory-2 (CDI-2) to 44 patients aged 9-18 years with CKD stages III-V. Criteria for depression were CDI-2 scores of ≥65 or an established diagnosis of depression recorded in the medical chart. Relative risks (RR) and 95 % confidence intervals (CI) were calculated to determine associations between patient characteristics and depression status. RESULTS Of the 44 patients enrolled in the study, 13 (30 %) met our criteria for depression, representing 18 % of patients aged <13 years and 34 % of those aged ≥13 years. Although not reaching statistical significance, the adjusted risk of depression was lower for patients with CKD duration of ≤3 years than for those with longer CKD duration (RR 0.19, 95 % CI 0.02, 1.53), and for those with CKD stage IV (RR 0.23, 95 % CI 0.05, 1.09) and CKD stage V (RR 0.13, 95 % CI 0.01, 1.07) compared to those with CKD stage III. CONCLUSIONS Our results indicate that depression is common in children with CKD, particularly for those with longstanding renal disease and at CKD stage III.
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Affiliation(s)
- Amy J. Kogon
- Division of Pediatric Nephrology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 17-102B, New York, NY 10032, USA
| | - Ann Vander Stoep
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Noel S. Weiss
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jodi Smith
- Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Joseph T. Flynn
- Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Elizabeth McCauley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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Bergman EJ, Diamond NJ. Sickle cell disease and the "difficult patient" conundrum. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2013; 13:3-10. [PMID: 23514384 DOI: 10.1080/15265161.2013.767954] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The convergence of sickle cell disease's unique political, historical, cultural, medical, and psychological dimensions begets an especially distressing plight for sufferers of the disease. Too often, this convergence results in sickle cell patients being classified as "difficult." As Autumn Fiester recently argued, traditional understanding of the "difficult" patient warrants reevaluation. By acknowledging the nuanced dimensions of sickle cell disease, we identify barriers to care particular to the disease, which further substantiate the need to redefine orthodox notions of the "difficult" patient. We support development of mechanisms in both health care provider education and third-party consultation support by the Ethics Consultation Service, or by other appropriately designated specialists, to respect the manifold dimensions of sickle cell disease as a necessary step toward the enhancement of clinical care for sickle cell patients.
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Affiliation(s)
- Edward J Bergman
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, 3401 Market Street, Suite 320, Philadelphia, PA 19104-3308, USA.
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Lu Y, Mak KK, van Bever HPS, Ng TP, Mak A, Ho RCM. Prevalence of anxiety and depressive symptoms in adolescents with asthma: a meta-analysis and meta-regression. Pediatr Allergy Immunol 2012; 23:707-15. [PMID: 22957535 DOI: 10.1111/pai.12000] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
It remains unclear whether anxiety and depressive symptoms are more prevalent in adolescents with asthma when compared with healthy individuals. This meta-analysis aimed to evaluate the difference in the aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls and to explore the underlying moderators that potentially explain the heterogeneity of the effect size. A meta-analysis of published work was performed using the random effects model. The differences in aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls were determined. Meta-regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. A total of eight studies were eligible for analysis. The aggregate prevalence of depressive and anxiety symptoms was significantly higher among 3546 adolescents with asthma than that of 24,884 controls (depression, 0.27; 95% CI, 0.18.6-0.39 vs. 0.13; 95% CI, 0.09-0.19; anxiety, 0.33; 95% CI, 0.19-0.52 vs. 0.21; 95% CI, 0.12-0.33). The risk of developing depression and anxiety is significantly higher among adolescents with asthma when compared with controls (depression: pooled odds ratio, 2.09; 95% CI, 1.65-2.64; p < 0.001; anxiety: pooled odds ratio, 1.83; 95% CI, 1.63-2.07; p < 0.001). Meta-regression revealed that the proportions of Caucasian (p = 0.008) and smokers (p < 0.001) were significant moderators which explained the significant heterogeneity when comparing the risk of developing depressive symptoms among adolescent asthma patients vs. controls while age, gender, and severity of asthma were not significant. Family doctors, pediatricians, and healthcare providers should formulate strategies to detect depressive and anxiety symptoms in adolescents with asthma and offer psychological interventions to reduce the burden of psychiatric comorbidity.
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Affiliation(s)
- Yanxia Lu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Molzon ES, Hullmann SE, Eddington AR, Mullins LL. Depression, Anxiety, and Health-Related Quality of Life in Adolescents and Young Adults With Allergies and Asthma. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/2150129711416501] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study sought to compare rates of depressive symptoms, anxious symptoms, and health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with allergies, asthma, and healthy controls. Participants were undergraduate students aged 18 to 29 years with self-reported allergies (N = 79), asthma (N = 79), and with no history of a chronic illness (N = 79). Participants completed the Center for Epidemiologic Studies Depression Scale, the Zung Self-Rating Anxiety Scale, and the SF-36 Health Survey Questionnaire as self-report measures of depressive symptoms, anxious symptoms, and HRQOL, respectively. A series of ANCOVAs (analysis of covariance; allergies vs asthma vs healthy controls) was conducted to examine differences between the groups. The results of the current examination suggest that AYAs with allergies are indeed at risk for experiencing higher rates of depressive and anxious symptoms and poorer HRQOL than healthy AYAs. Furthermore, they are experiencing psychosocial concerns on par with or worse than those of AYAs with asthma. Allergies, often perceived as a relatively benign illness, have commonly been overlooked in discussions of psychosocial concerns related to chronic illnesses. The results of the current study suggest that young adults with allergies are also an important population to examine.
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Affiliation(s)
| | | | | | - Larry L. Mullins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
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Reynolds KA, Helgeson VS. Children with diabetes compared to peers: depressed? Distressed? A meta-analytic review. Ann Behav Med 2011; 42:29-41. [PMID: 21445720 PMCID: PMC3140576 DOI: 10.1007/s12160-011-9262-4] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND It is not clear from the literature whether children with diabetes have more psychological difficulties than their peers. PURPOSE This study aims to use meta-analysis to determine if children with diabetes differ from children without a chronic illness in a variety of domains reflecting psychological well-being. METHOD A meta-analysis was undertaken of 22 studies that compared children with diabetes to a comparison group. Outcomes included depression, anxiety, behavioral problems, and related constructs. RESULTS Children with diabetes were more likely than comparison groups to experience a variety of psychological difficulties. However, these effects were small to medium in magnitude and were typically smaller among more recent studies and studies with well-matched comparison groups. CONCLUSIONS This meta-analysis suggests that children with diabetes are at slightly elevated risk for psychological difficulties. Future work will need to help identify children at the highest risk, and to identify factors associated with resilience.
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Affiliation(s)
| | - Vicki S. Helgeson
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA,
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Honey A, Emerson E, Llewellyn G. The mental health of young people with disabilities: impact of social conditions. Soc Psychiatry Psychiatr Epidemiol 2011; 46:1-10. [PMID: 19894012 DOI: 10.1007/s00127-009-0161-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2009] [Accepted: 10/20/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Young people with disabilities have poorer mental health than their non-disabled peers. However, people with disabilities are more likely than others to experience financial hardship and low social support, both of which have been linked with poor mental health outcomes. This article explores the extent to which the relatively poor mental health of young people with disabilities is related to the social conditions in which they live. METHODS Secondary analysis was performed on Wave 6 (2006) of the survey of Household Income and Labour Dynamics in Australia (HILDA). This nationally representative sample included 3,392 young Australians, aged 15-29, of whom 475 reported having a long-term health condition, impairment or disability. RESULTS Young people with disabilities reported poorer mental health than their non-disabled peers. However, this relationship was moderated by both social adversity and social support, with minimal differences in mental health observed between the groups under conditions of high social support and low financial hardship. DISCUSSION The results suggest that disability represents a potential adversity that may be exacerbated or ameliorated by the effects of wealth/financial hardship and social support. CONCLUSION It may be possible to improve the mental health of disabled people by addressing their social exclusion.
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Affiliation(s)
- Anne Honey
- Australian Family and Disability Studies Research Collaboration, Faculty of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW, 1825, Australia.
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Psychiatric Disorders in a Sample of Saudi Arabian Adolescents with Sickle Cell Disease. CHILD & YOUTH CARE FORUM 2009. [DOI: 10.1007/s10566-009-9091-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Emotional health of Canadian and Finnish students with disabilities or chronic conditions. Int J Rehabil Res 2009; 32:154-61. [PMID: 19458524 DOI: 10.1097/mrr.0b013e32831e452e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to investigate the dimensions of emotional health in two population-based groups (Finland and Canada) of adolescents (ages 13 and 15 years) who self-identify as having a disability or chronic condition, as conceptualized by the WHO International Classification of Functioning, Disability and Health. Data from the 2002 WHO Health Behaviour in School-aged Children survey were used to compare the prevalence of emotional health (items on feeling low, feeling nervous) within and between countries. Eighteen percent of the Canadian and Finnish samples indicated they had a long-time disability, illness or medical condition. Canadian adolescents with disability or chronic conditions felt low significantly more frequently than their classmates without disability or chronic conditions. In both countries, students with disabilities who had more than one functional difficulty were significantly more likely to report feeling low and nervous. These results illustrate that the severity of disability as measured by the number of functional difficulties, and not merely the presence of disability or chronic condition, or particular functional difficulties, may play an important role in the emotional health of adolescents. Health promotion programs may use this information to guide practice to support the emotional health of students with disabilities.
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Betz CL, Redcay G. AN EXPLORATORY STUDY OF FUTURE PLANS AND EXTRACURRICULAR ACTIVITIES OF TRANSITION-AGE YOUTH AND YOUNG ADULTS. ACTA ACUST UNITED AC 2009; 28:33-61. [PMID: 15824028 DOI: 10.1080/01460860590916753] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A descriptive profile of the health related concerns, school-related and extracurricular activities, employment-related activities, social relationships and future plans of 25 transition-aged youth and young adults (ages 14 to 21 years) were conducted. The findings of this exploratory study provide insight on the impact their chronic condition had upon all aspects of their lives. Sixty percent of respondents indicated they had missed school due to their condition and a third of the respondents had not completed high school. Health care professionals usually were not identified as participatory in youth transition planning. The majority of these transition-aged youth and young adults had positive feelings towards their school experience, although most of the respondents were not involved in school projects or clubs, which suggests their participation in school-related extra-curricular activities was limited. Nearly all of the respondents had some form of employment experience. Most of their work experiences were nonpaying jobs such as serving as a volunteer and participating in school-based employment training. Nearly all of the respondents expressed desires for sustainable employment and fiscal and social independence. Most of the respondents reported having social relationships with just less than half reporting seeing friends outside of school.
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Affiliation(s)
- Cecily L Betz
- USC University Center of Excellence for Developmental Disabilities, Childrens Hospital Los Angeles, California 90033, USA.
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Moreau D, Kalaboka S, Choquet M, Annesi-Maesano I. Asthma, obesity, and eating behaviors according to the diagnostic and statistical manual of mental disorders IV in a large population-based sample of adolescents. Am J Clin Nutr 2009; 89:1292-8. [PMID: 19321566 DOI: 10.3945/ajcn.2008.26954] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Obesity is related to asthma, but factors influencing this relation have not been clearly defined. OBJECTIVE This study was designed to assess the role of eating behaviors and weight concerns in the association between obesity and asthma. DESIGN A population-based sample of 11,710 adolescents, recruited from 186 secondary schools of 8 educational districts in France, completed a self-administered standardized questionnaire including DSM IV (Diagnostic and Statistical Manual of Mental Disorders) questions on eating disorders. RESULTS Obesity (body mass index >/=95th percentile according to age and sex) was associated with asthma in girls (odds ratio: 1.48; 95% CI: 1.05, 2.08) but not in boys (odds ratio: 1.07; 95% CI: 0.75, 1.54). Both obese and asthmatic adolescents were more likely to have abnormal eating behaviors and weight concerns (P < 0.05). In an adjusted polytomous logistic model with 4 categories based on the presence and/or the absence of asthma and obesity as the dependent variable, the odds ratio for weight concerns increased from a minimum value for asthmatic nonobese adolescents (odds ratio: <1.5; P < 0.03) to a maximum value for asthmatic obese adolescents (odds ratio: >6.3; P < 0.001) with nonasthmatic, nonobese adolescents as the reference group. Similar patterns were observed for overweight. CONCLUSIONS Our data suggest that, besides well-known factors such as genetic background, direct mechanical effects, and reduced physical activity, abnormal eating behaviors and weight concerns might intervene in the relation between obesity and asthma. Psychosocial dimension has to be considered to disentangle the complex relation between obesity and asthma in adolescence in view of prevention.
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Affiliation(s)
- David Moreau
- From INSERM, Epidemiology of Allergic and Respiratory Diseases, Paris, France
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Bakare MO, Omigbodun OO, Kuteyi OB, Meremikwu MM, Agomoh AO. Psychological complications of childhood chronic physical illness in Nigerian children and their mothers: the implication for developing pediatric liaison services. Child Adolesc Psychiatry Ment Health 2008; 2:34. [PMID: 19019212 PMCID: PMC2596085 DOI: 10.1186/1753-2000-2-34] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 11/19/2008] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Pediatric liaison services attending to the psychological health needs of children with chronic physical illness are limited or virtually non-existent in Nigeria and most sub-Saharan African countries, and psychological problems complicate chronic physical illness in these children and their mothers. There exist needs to bring into focus the public health importance of developing liaison services to meet the psychological health needs of children who suffer from chronic physical illness in this environment. Sickle cell disease (SCD) and juvenile diabetes mellitus (JDM) are among the most common chronic physical health conditions in Nigerian children. This study compared the prevalence and pattern of emotional disorders and suicidal behavior among Nigerian children with SCD, JDM and a group of healthy children. Psychological distress in the mothers of these children that suffer chronic physical illness was also compared with psychological distress in mothers of healthy control children. METHODS Forty-five children aged 9 to 17 years were selected for each group of SCD, JDM and controls. The SCD and JDM groups were selected by consecutive clinic attendance and the healthy children who met the inclusion criteria were selected from neighboring schools. The Youth version of the Computerized Diagnostic Interview Schedule for Children, version IV (C- DISC- IV) was used to assess for diagnosis of emotional disorders in these children. Twelve-item General Health Questionnaire (GHQ - 12) was used to assess for psychological distress in mothers of these children and healthy control children. RESULTS Children with JDM were significantly more likely to experience DSM - IV emotional disorders than children with SCD and the healthy group (p = 0.005), while children with JDM and SCD were more likely to have 'intermediate diagnoses' of emotional disorders (p = 0.0024). Children with SCD and JDM had higher rates of suicidal ideation when compared to healthy control children and a higher prevalence of maternal psychological distress was found in their mothers when compared to the mothers of healthy children (p = 0.035). CONCLUSION The higher prevalence of emotional disorders and suicidal ideation among children with SCD and JDM points to a need for development of liaison services in pediatric facilities caring for children with chronic physical illness to ensure holistic approach to their care. The proposed liaison services would also be able to provide family support interventions that would address the psychological distress experienced by the mothers of these children.
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Affiliation(s)
- Muideen O Bakare
- Child and Adolescent Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria
| | | | - Olugbenga B Kuteyi
- Child and Adolescent Unit, Federal Psychiatric Hospital, Calabar, Nigeria
| | - Martin M Meremikwu
- Department of Pediatrics, College of Medical Sciences, University of Calabar, Nigeria
| | - Ahamefule O Agomoh
- General/Forensic Psychiatry Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria
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Rofey DL, Szigethy EM, Noll RB, Dahl RE, Lobst E, Arslanian SA. Cognitive-behavioral therapy for physical and emotional disturbances in adolescents with polycystic ovary syndrome: a pilot study. J Pediatr Psychol 2008; 34:156-63. [PMID: 18556675 DOI: 10.1093/jpepsy/jsn057] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility and effectiveness of an enhanced cognitive-behavioral therapy (CBT), Primary and Secondary Control Enhancement Training (PASCET-PI-2), for physical (obesity) and emotional (depression) disturbances in adolescents with polycystic ovary syndrome (PCOS). METHOD In an open trial, 12 adolescents with PCOS, obesity, and depression underwent eight weekly sessions and three family-based sessions of CBT enhanced by lifestyle goals (nutrition and exercise), physical illness narrative (meaning of having PCOS), and family psychoeducation (family functioning). RESULTS Weight showed a significant decrease across the eight sessions from an average of 104 kg (SD = 26) to an average of 93 kg (SD = 18), t(11) = 6.6, p <.05. Depressive symptoms on the Children's Depression Inventory significantly decreased from a mean of 17 (SD = 3) to a mean of 9.6 (SD = 2), t(11) = 16.8, p <.01. CONCLUSION A manual-based CBT approach to treat depression in adolescents with PCOS and obesity appears to be promising.
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Abstract
The adolescents with asthma are a distinct group of patients with different problems and needs compared to children and adults. Specific issues of asthma in adolescence are the variability of the clinical spectrum, the presence of particular risk factors for the persistence of symptoms, underdiagnosis and undertreatment of the disease. Refusal of the sick role, denial of symptoms, carelessness about dangerous inhalation exposure, erratic self-medication, overexertion without taking precautions against exercise-induced asthma, and a poor relationship between patients, their families, and often doctors are the main obstacles to successful management of asthma in this critical age. There are also major problems of compliance for these patients. The goal of optimal quality of life will be achieved only if the physician thoroughly understands the adolescent's needs and provides optimal care.
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Abstract
AIM To study the behaviour/emotional problems and depression in adolescents with and without physical illnesses; to compare the same psychological parameters in adolescents with different disorders. METHODS The sample consisted of 148 adolescents aged 13-16 years with one of the following physical chronic conditions: diabetes (n = 55), asthma (n = 59), or epilepsy (n = 59). Comparative data were obtained from a group of 301 schoolchildren. Test batteries (Child Behaviour Check-List, Youth Self Report, Beck Depression Inventory, socio-economic status questions) were individually completed by adolescents and their mothers. RESULTS Overall adolescents with physical illness had more behaviour/emotional problems and were more depressed compared to controls although results varied according to the informants and the disease severity. Two risk groups were revealed: girls with asthma and boys with epilepsy. CONCLUSION Our results suggest that mental health in adolescents with chronic physical illnesses is poorer than in controls and their mental health state is very much associated with the disease severity. The findings of the study can help to develop disease targeted and comprehensive interventions in outpatient clinics of Northern Russia in order to reduce behaviour and mood disorders in adolescents with chronic physical illnesses and therefore to smooth the transition through their teenage years.
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Affiliation(s)
- A Zashikhina
- Division of Child and Adolescent Psychiatry, Umea University, Sweden.
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Benton TD, Ifeagwu JA, Smith-Whitley K. Anxiety and depression in children and adolescents with sickle cell disease. Curr Psychiatry Rep 2007; 9:114-21. [PMID: 17389120 DOI: 10.1007/s11920-007-0080-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A growing body of evidence suggests that depressive disorders and anxiety disorders are much more prevalent among medically ill children and adolescents when compared with the general population, and that the presence of comorbidity may adversely affect medical outcomes and quality of life. Whereas the prevalence and impact of anxiety and depressive disorders have been described in chronic conditions such as asthma, diabetes, and epilepsy, much less is known about sickle cell disease (SCD), a disorder that affects more than 70,000 Americans, primarily those of African and Mediterranean descent. A hallmark of this disorder is recurrent, acute, and chronic pain that often requires emergency management and hospitalization. Medical advances in the treatment of this illness have transformed SCD from a condition associated with very early morbidity and mortality into a chronic condition of adulthood. This article reviews the evidence describing our knowledge of anxiety and depression in children and adolescents with SCD, its clinical impact, and effectiveness of interventions.
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Affiliation(s)
- Tami D Benton
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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Preechawong S, Zauszniewski JA, Heinzer MMV, Musil CM, Kercsmar C, Aswinanonh R. Relationships of family functioning, self-esteem, and resourceful coping of Thai adolescents with asthma. Issues Ment Health Nurs 2007; 28:21-36. [PMID: 17130005 DOI: 10.1080/01612840600996208] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Within the context of Rosenbaum's theory of learned resourcefulness, this correlational study examined the relationships among family functioning, self-esteem, and resourceful coping in Thai adolescents with asthma. A convenience sample of 132 Thai adolescents (aged 12-17 years) with asthma was recruited from the outpatient asthma clinics of four hospitals in Bangkok. Self-administered questionnaires included an assessment of demographic information and asthma status, the revised Family APGAR, the Rosenberg Self-Esteem Scale, and the Children's Self-Control Scale. Hierarchical multiple regression analysis was used to examine the relationships among variables. Effective family functioning had a significant positive effect on self-esteem (beta = .27, p < .01) and resourceful coping (beta = .30, p < .01), controlling for gender and age. However, self-esteem was not significantly correlated with resourceful coping (beta = .15, p = .08). The findings suggest that nursing interventions should take into account the role of family functioning in promoting self-esteem and resourceful coping in Thai adolescents with asthma. Recommendations for future research include replication of the study with a larger sample of adolescents with asthma and with adolescents with other chronic illnesses.
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Affiliation(s)
- Sunida Preechawong
- Faculty of Nursing, Chulalongkorn University, Pyathai Road, Pathumwan, Bangkok 10330, Thailand. Sunida.P.@Chula.ac.th
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Erickson JD, Patterson JM, Wall M, Neumark-Sztainer D. Risk Behaviors and Emotional Well-Being in Youth With Chronic Health Conditions. CHILDRENS HEALTH CARE 2005. [DOI: 10.1207/s15326888chc3403_2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hocking MC, Lochman JE. Applying the Transactional Stress and Coping Model to Sickle Cell Disorder and Insulin-Dependent Diabetes Mellitus: Identifying Psychosocial Variables Related to Adjustment and Intervention. Clin Child Fam Psychol Rev 2005; 8:221-46. [PMID: 16151619 DOI: 10.1007/s10567-005-6667-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This review paper examines the literature on psychosocial factors associated with adjustment to sickle cell disease and insulin-dependent diabetes mellitus in children through the framework of the transactional stress and coping (TSC) model. The transactional stress and coping model views adaptation to a childhood chronic illness as mediated by several psychosocial factors. This review examines the utility of the model in explaining adjustment in two different childhood diseases, identifies needed research and intervention targets, as well as highlights potential changes to the model. The major conclusions of this review suggest that, in addition to child-specific factors, family functioning is an area that interventions should address in sickle cell disease and insulin-dependent diabetes mellitus.
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Affiliation(s)
- Matthew C Hocking
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama 35406, USA.
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Slattery MJ. Psychiatric Comorbidity Associated with Atopic Disorders in Children and Adolescents. Immunol Allergy Clin North Am 2005; 25:407-20, viii. [PMID: 15878463 DOI: 10.1016/j.iac.2005.02.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article examines evidence of an association between psychiatric disorders and atopic disorders in children and adolescents. Findings are discussed within a developmental framework and compared with adult studies, when available, to illustrate similarities and differences between youth and adults. Finally, the article discusses the clinical relevance of comorbid psychiatric and atopic disorders.
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Affiliation(s)
- Marcia J Slattery
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Wisconsin Medical School, 6001 Research Park Boulevard, Madison, WI 53719, USA
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Abstract
Paediatric asthma has a considerable impact on both society, in terms of healthcare resources, and patients and their families, in terms of impaired quality of life. The principal goals of asthma treatment are to achieve and maintain control of symptoms. Achieving these goals may involve long-term use of appropriate medication in the form of an inhaled corticosteroid (ICS) and a long-acting ss-agonist (LABA). However, many patients with paediatric asthma are not currently achieving symptom control. The main barriers to asthma control are underuse of effective therapies, inappropriate choice of drug delivery devices and a lack of patient or parent/guardian education regarding the disease and its treatment. By addressing and overcoming these barriers to asthma control, the quality of life of patients and their families may be significantly improved.
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Affiliation(s)
- Sadie Clayton
- University Hospital North Staffordshire, Academic Department of Paediatrics, City General Site, Stoke on Trent, Staffordshire
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Szigethy E, Whitton SW, Levy-Warren A, DeMaso DR, Weisz J, Beardslee WR. Cognitive-behavioral therapy for depression in adolescents with inflammatory bowel disease: a pilot study. J Am Acad Child Adolesc Psychiatry 2004; 43:1469-77. [PMID: 15564816 DOI: 10.1097/01.chi.0000142284.10574.1f] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the safety and feasibility of cognitive-behavioral therapy (CBT) for depression in physically ill adolescents. METHOD In an open trial, 11 adolescents (12-17 years) with inflammatory bowel disease and either major or minor depression underwent 12 sessions of a manual-based CBT enhanced by social skills, physical illness narrative, and family psychoeducation components. Standardized instruments assessed pre- to posttreatment changes in depression, physical health, global psychological functioning, and social functioning. Perceived helpfulness and satisfaction with CBT were assessed. RESULTS There were significant reductions in DSM-IV depression diagnoses and depressive symptoms and improvements in global psychological and social functioning. Adolescents' perceptions of their general health and physical functioning improved, although illness severity measures were unchanged. High subject satisfaction and helpfulness ratings for CBT were found along with no adverse events and high subject adherence. CONCLUSIONS A manual-based CBT approach adapted to treat depression in physically ill adolescents appears to be a safe, feasible, and promising intervention.
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Affiliation(s)
- Eva Szigethy
- Department of Psychiatry, Children's Hospital Boston, Boston, MA 02115, USA.
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Szigethy E, Levy-Warren A, Whitton S, Bousvaros A, Gauvreau K, Leichtner AM, Beardslee WR. Depressive symptoms and inflammatory bowel disease in children and adolescents: a cross-sectional study. J Pediatr Gastroenterol Nutr 2004; 39:395-403. [PMID: 15448431 DOI: 10.1097/00005176-200410000-00017] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES This study assessed the rates of depressive symptoms in older children and adolescents with inflammatory bowel disease (IBD) and the associations between depressive symptoms and IBD disease characteristics. METHODS One hundred and two youths (aged 11-17 years) with IBD seen consecutively in a gastroenterology clinic were screened for depressive symptoms using the Children's Depression Inventory (CDI). Subjects with CDI scores > or = 12 were evaluated for current psychiatric diagnoses using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Disease characteristics examined included IBD type, duration, current severity, course, age at diagnosis and steroid treatment. RESULTS Of the total sample, 25 (24.5%) had a CDI score > or = 12, consistent with clinically significant depressive symptoms. Nineteen of 25 qualified subjects participated in the K-SADS-PL semi-structured interview and 16 of 19 met criteria for major or minor depressive disorder. Mean CDI scores positively correlated with age at IBD diagnosis but not with IBD type, duration or course. Youths with moderate/severe current IBD-related symptoms had significantly higher mean CDI scores than those with inactive disease activity. Anhedonia, fatigue and decreased appetite were selectively correlated with IBD disease severity. Subjects on steroids were more likely to have CDI scores > or = 12, and those with such scores were on higher doses of steroids than subjects without clinically significant depressive symptoms (both P values < 0.05). CONCLUSIONS These findings support the recommendation that adolescents with IBD in outpatient medical care settings, particularly older adolescents and those on steroids, should be screened for depression.
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Affiliation(s)
- Eva Szigethy
- Department of Psychiatry, Children's Hospital, Boston, Massachusetts 02115, USA.
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Abstract
The prevalence of chronic conditions among adolescents is difficult to assess due to the lack of quality data focusing specifically on this age group, as well as the diversity in methodology and definitions used. However, surveys carried out by self administered questionnaires among in-school adolescent populations indicate that around 10% of adolescents suffer from such a condition. The aim of this paper is to analyse the reciprocal effects of chronic conditions and adolescent development by reviewing the effect of chronic disease on growth and puberty and on psychosocial development, and the effect of developmental issues on the course and management of chronic disease.
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Affiliation(s)
- J-C Suris
- Groupe de Recherche sur la Santé des Adolescents (GRSA), Institut Universitaire de Médecine Sociale et Préventive (IUMSP), Lausanne, Switzerland.
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Dantzer C, Swendsen J, Maurice-Tison S, Salamon R. Anxiety and depression in juvenile diabetes: a critical review. Clin Psychol Rev 2004; 23:787-800. [PMID: 14529698 DOI: 10.1016/s0272-7358(03)00069-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A critical examination of the recent literature on anxiety and depression in juvenile diabetes is presented. The objectives of this review are: (1) to determine the general association of psychological factors, especially anxiety and depression, with diabetes, (2) to examine the specific association of anxiety and depression with metabolic control, and (3) to propose methodological changes that are needed to advance future research in this field. The major conclusions of this review support the notion of a general association of psychological disorders with juvenile diabetes. However, while anxiety and depression appear to play an important and complex role in determining adaptation to the disease, their relationship to metabolic control does not yet appear clear. Additional prospective and controlled studies as well as multivariate models of chronic disease are now necessary to more fully understand the etiology and impact of these disorders in the adolescent population.
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Affiliation(s)
- Cécile Dantzer
- Laboratory of Clinical Psychology and Psychopathology, University of Savoie, 73011, Cedex, Chambery, France.
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Penkower L, Dew MA, Ellis D, Sereika SM, Kitutu JMM, Shapiro R. Psychological distress and adherence to the medical regimen among adolescent renal transplant recipients. Am J Transplant 2003; 3:1418-25. [PMID: 14525604 DOI: 10.1046/j.1600-6135.2003.00226.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This longitudinal pilot study of adolescent renal transplant recipients (a) describes the prevalence of psychological distress, (b) describes the prevalence of nonadherence, and (c) explores the association between the recipient's psychological distress and his/her subsequent medical adherence. Twenty-two adolescents, aged 13-18 years, completed two interviews that were separated by approximately 12 months. Psychological distress was assessed in three domains: symptoms of depression, anxiety, and anger. Adherence was assessed in three domains: medication taking, blood work, and clinic attendance. At the initial interview, 36.4% had symptoms of depression, 36.4% endorsed anxiety, and 18.2% endorsed excessive state anger. Non-adherence rates were 13.6% for medication, 22.7% for blood work, and 50% for missed clinic. At the second interview, nonadherence with medication remained the same and the other domains decreased. Our small pilot sample, however, limited our ability to detect statistically significant changes over time. Predictive analyses demonstrated that adolescents with excessive anger were at greater risk for subsequently missing medications than adolescents without excessive anger. These findings suggest that while symptoms of depression and anxiety are observed among some adolescents with renal transplants, only anger is associated with elevated risk for nonadherence with medication.
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Affiliation(s)
- Lili Penkower
- Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. lilip+@pitt.edu
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Tanyi RA. Sickle cell disease: health promotion and maintenance and the role of primary care nurse practitioners. ACTA ACUST UNITED AC 2003; 15:389-97. [PMID: 14560435 DOI: 10.1111/j.1745-7599.2003.tb00413.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To discuss the role of nurse practitioners (NPs) with regard to early identification of affected individuals, effective monitoring and screening, effective pain management and prophylaxis, and health education for patients with sickle cell disease (SCD). DATA SOURCES Electronic database searches were performed using Medline, Cinahl, and PsycINFO. Data were obtained from medical textbooks, research, and review articles. CONCLUSIONS SCD is a chronic inherited disease belonging to a group of conditions called hemoglobinopathies. Individuals with SCD often require close medical care from specialists. Nonetheless, NPs are in ideal positions to facilitate the health promotion and health maintenance necessary to decrease the high rate of morbidity and mortality associated with this disease. IMPLICATIONS FOR PRACTICE NPs must understand the importance of early identification of affected individuals, effective monitoring and screening, effective monitoring and screening, effective pain treatment, and prophylaxis. The unpredictable trajectory of SCD can lead to frustration, fear, helplessness, hopelessness, and emotional distress. Ineffective pain management is a major problem for people with SCD. NPs can overcome this problem by initiating effective and prompt pain management in a nonjudgmental manner.
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Affiliation(s)
- Ruth A Tanyi
- Family Practice Department of the Allina Medical Clinic, Coon Rapids, Minnesota, USA.
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Morrison KM, Goli A, Van Wagoner J, Brown ES, Khan DA. Depressive Symptoms in Inner-City Children With Asthma. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2002; 4:174-177. [PMID: 15014704 PMCID: PMC327131 DOI: 10.4088/pcc.v04n0501] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 09/08/2002] [Accepted: 11/06/2002] [Indexed: 10/20/2022]
Abstract
BACKGROUND: Asthma is a sometimes severe respiratory illness with an increased prevalence, especially in low-income, minority, and inner-city populations, over the past 2 decades. Prior reports have suggested a link between depression and asthma deaths. However, no studies have examined the relationship between objective measures of asthma severity and clinician-rated depressive symptom severity. METHOD: In this pilot study, 46 children receiving treatment at an inner-city asthma clinic were assessed with the Children's Depression Rating Scale, Revised (CDRS-R). The current percentage of forced expiratory volume in 1 second (FEV(1)%) predicted and the inhaled steroid dose were recorded, as were oral steroid use, emergency room visits, and hospitalizations in the preceding year. RESULTS: Depressive symptoms were common in this sample, with 30% (N = 14) of the participants having CDRS-R scores consistent with likely, very likely, or almost certain major depressive disorder. When mean CDRS-R scores were compared between the sample divided by these asthma severity measures, only hospitalizations in the past year was associated with higher depressive symptom scores (p =.03). CONCLUSION: These findings suggest that in the patient sample studied, depressive symptoms appear to be common. However, depressive symptom severity is related only to hospitalization, not other measures of asthma severity. Larger studies are needed to confirm these findings and determine if other variables such as family history of depression or subjective assessment of asthma severity explain the high prevalence of depressive symptoms in these patients.
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Affiliation(s)
- Kristine M. Morrison
- Science Teacher Access to Resources at Southwestern Program and the Departments of Internal Medicine and Psychiatry, University of Texas Southwestern Medical Center, Dallas
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Affiliation(s)
- Sandra Kim
- Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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