Psychological complications of childhood chronic physical illness in Nigerian children and their mothers: the implication for developing pediatric liaison services
Tóm tắt
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. 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. 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). 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.
Tài liệu tham khảo
Ohaeri JU, Shokunbi WA, Akinlade KS, Dare LO: The Psychosocial problems of sickle cell disease sufferers and their methods of coping. Soc Sci Med. 1995, 40 (7): 955-60. 10.1016/0277-9536(94)00154-L.
Ohaeri JU, Shokunbi WA: Psychosocial burden of sickle cell disease on care givers in a Nigerian setting. J Natl Med Assoc. 2002, 94 (12): 1058-70.
Bakare MO: Case Report: Psychosis in an adolescent with sickle cell disease. Child and Adolescent Psychiatry and Mental Health. 2007, 1: 6-10.1186/1753-2000-1-6.
Serjeant GR: Sickle cell Disease. 1985, Oxford University Press, London
Fleming AF, Storey JL, Molineaus E, Iroko A, Atai ED: Abnormal Hemoglobins in the Sudan Savannah of Nigeria. Ann Trop Med Parasit. 1979, 73: 161-168.
Demlouji NF, Georgopoulos A, Kevess-Cohen R: Social disability and psychiatric morbidity in sickle cell anemia and diabetes patients. Psychosomatics. 1982, 23: 925-931.
Udofia O, Oseikhuemen AE: Psychiatric morbidity in patients with sickle cell anemia. West Afr J Med. 1996, 15 (4).
Hilton C, Osborn M, Knight S, Singhal A, Serjeant G: Psychiatric complications of homozygous sickle cell disease among young adults in the Jamaican Cohort study. Br J Psychiatry. 1997, 170: 67-76. 10.1192/bjp.170.1.69.
Iloeje SO: Psychiatric morbidity among children with sickle – cell disease. Dev Med Child Neurol. 1991, 33 (12): 1087-94.
W.H.O.: International Classification of Diseases, (ICD- 10). World Health Organization (WHO). 1992, 10
Diagnostic and Statistical Manual of Mental Disorders, (DSM- IV). American Psychiatric Association. 1994, 4
Sourander A, Helstela L, Helenius H: Parent-adolescent agreement on emotional and behavioral problems. Soc Psychiatry Psychiatr Epidemiol. 1999, 34 (12): 657-663. 10.1007/s001270050189.
Zukauskiene R, Pilkauskaite-Valickiene R, Malinauskiene O, Krataviciene R: Evaluating behavioral and emotional problems with the Child Behavior Checklist and Youth Self-Report Scales: cross-informant and longitudinal associations. Medicina (Kaunas). 2004, 40 (2): 169-177.
Woo BS, Ng TP, Fung DS, Chan YH, Lee YP, Koh JP, Cai Y: Emotional and behavioral problems in Singaporean children based on parent, teacher and child reports. Singapore Med J. 2007, 48 (12): 1100-1106.
Afoke AO, Ejeh NM, Nwosu EN, Okafor CO, Udeh NJ, Ludwigsson J: Prevalence and clinical picture of IDDM in Nigerian Igbo School children. Diabetes Care. 1992, 15 (10): 1310-2. 10.2337/diacare.15.10.1310.
Seigel WM, Golden NH, Gough JW, Lashley MS, Sacker IM: Depression, self-esteem and life events in adolescents with chronic diseases. J Adolesc Health Care. 1990, 11 (6): 501-4. 10.1016/0197-0070(90)90110-N.
Blanz BJ, Rensch-Riemann BS, Fritz-Sigmund DI, Schmidt MH: IDDM is a risk factor for adolescent psychiatric disorders. Diabetes Care. 1993, 16 (12): 1621-3. 10.2337/diacare.16.12.1579.
Grey M, Cameron ME, Lipman TH, Thurber FW: Psychosocial status of children with diabetes in the first 2 years after diagnosis. Diabetes Care. 1995, 18 (10): 1330-6. 10.2337/diacare.18.10.1330.
Schiffrin A: Psychosocial issues in pediatric diabetes. Curr Diab Rep. 2001, 1 (1): 33-40. 10.1007/s11892-001-0008-8.
Martinez-Chammorro MJ, Lastra Martinez I, Luzuriaga Tomas C: Psychopathology and child and adolescent type 1 diabetes mellitus outcome. Actas Esp Psiquiatr. 2002, 30 (3): 175-81.
Kovacs M, Goldston D, Obrosky DS, Bonar LK: Psychiatric disorders in youths with IDDM; rates and risk factors. Diabetes Care. 1997, 20 (1): 36-44. 10.2337/diacare.20.1.36.
Jacobson AM, Hauser ST, Lavori P, Willett JB, Cole CF, Wolfsdorf JL, Dumont RH, Wertlieb D: Family environment and glycemic control: a four-year prospective study of children and adolescents with insulin-dependent diabetes mellitus. Psychosom Med. 1994, 56 (5): 401-409.
Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME: NIMH Diagnostic Interview Schedule for Children, Version IV (NIMH DISC- IV): description, differences from previous versions and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry. 2000, 39 (1): 28-38. 10.1097/00004583-200001000-00014.
Goldberg DP: The detection of psychiatric illness by questionnaire. Mausdsley monograph. 1972, Oxford University Press, Oxford, 21
Gureje O, Obikoya B: The GHQ-12 as a Screening Tool in a Primary Care Setting. Soc Psychiatry Psychiatr Epidemiol. 1990, 25: 276-280. 10.1007/BF00788650.
Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C: The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997, 27 (1): 191-197. 10.1017/S0033291796004242.
Picardi A, Abeni D, Mazzotti E, Fassone G, Lega I, Ramieri L, Sagoni E, Tiago A, Pasquini P: Screening for psychiatric disorders in patients with skin diseases: a performance study of the 12-item General Health Questionnaire. J Psychosom Res. 2004, 57 (3): 219-223. 10.1016/S0022-3999(03)00619-6.
Yang YM, Cepeda M, Price C, Shah A, Mankad V: Depression in children and adolescents with sickle – cell disease. Arch Pediatr Adolesc Med. 1994, 148 (5): 457-60.
Levene MI: Jolly's Diseases of Children. 1996, Blackwell Scientific Publication, 6
Theodoulou M, Harriss L, Hawton K, Bass C: Pain and deliberate self-harm; an important association. Psychosom Res. 2005, 58 (4): 317-20. 10.1016/j.jpsychores.2004.10.004.
Edwards RR, Smith MT, Kudel I, Havthornthwaite J: Pain-related catastrophizing as a risk factor for suicidal ideation in chronic pain. Pain. 126 (1–3): 272-9.
Omigbodun OO, Adebayo E, Gureje O: Detection of childhood mental health problems by doctors working in a primary care service. The Nig Postgrad Med J. 1999, 6 (1): 1-4.
Civic D, Hold VL: Maternal depressive symptoms and child behavior problems in a nationally representative normal birth weight sample. Maternal Child Health J. 2000, 4 (4): 215-21. 10.1023/A:1026667720478.
Gureje O, Omigbodun OO: Children with mental disorders in primary care: Functional status and risk factors. Acta Psychiatr Scand. 1995, 92;: 310-314. 10.1111/j.1600-0447.1995.tb09588.x.
Ireys HT, Chernoff R, DeVet KA, Kim Y: Maternal outcomes of a randomized controlled trial of a community-based support program for families of children with chronic illnesses. Arch Pediatr Adolesc Med. 2001, 155 (7): 771-7.
Omigbodun OO: Psychosocial issues in a child and adolescent psychiatric clinic population in Nigeria. Soc Psychiatry Psychiatr Epidemiol. 2004, 39 (8): 667-672. 10.1007/s00127-004-0793-x.
Adewuya AO, Ola BA: Prevalence of and risk factors for anxiety and depressive disorders in Nigerian adolescents with epilepsy. Epilepsy Behav. 2005, 6 (3): 342-347. 10.1016/j.yebeh.2004.12.011.