Depression and quality of life in children with sickle cell disease: the effect of social support

BMC Psychiatry

Hayat Zakaria Kamfar¹  Mohammad Gamal Sehlo² 

[1] Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;Department of Psychiatry, Zagazig University, Zagazig, Egypt

关键词: Sickle cell disease;    Social support;    Quality of life;    Depression;   

Others  :  1171023
DOI  :  10.1186/s12888-015-0461-6

 received in 2013-10-21, accepted in 2015-03-30,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Sehlo and Kamfar; licensee BioMed Central.

【 参考文献 】

• [1]Leikin SL, Gallagher D, Kinney TR, Sloane D, Klug P, Rida W: Mortality in children and adolescents with sickle cell disease. Pediatrics 1989, 84:500-8.
• [2]Midance K, Shand P: Family and social issues in sickle cell disease. Health Visitor 1992, 65:441-3.
• [3]Schatz JC, Puffer E: Europsychological Aspects of Sickle Cell Disease. In Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease. Edited by Brown RT. Oxford University Press, New York; 2006:449-70.
• [4]Patten SB, Beck CA, Kassam A, Williams JV, Barbui C, Metz LM: Long-term medical conditions and major depression: strength of association for specific conditions in the general population. Can J Psychiatry 2005, 50:195-202.
• [5]Chapman DP, Perry GS, Strine TW: The vital link between chronic disease and depressive disorders. Prev Chronic Dis 2005, 2:A14.
• [6]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, 11:501-4.
• [7]Doglan JI: Depression in children. Pediatr Ann 1990, 19:46-50.
• [8]Jerrell JM, Tripathi A, Mcintyre RS. Prevalence and treatment of depression in children and adolescents with sickle cell disease: a retrospective cohort study. Prim Care Companion CNS Disord. 2011;13(2). doi: 10.4088/PCC.10m01063.
• [9]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.
• [10]Benton TD, Boyd R, Ifeagwu JA, Feldtmose E, Smith-Whitley K: Psychiatric diagnosis in adolescents with sickle cell disease: a preliminary report. Curr Psychiatry Rep 2011, 13:111-5.
• [11]Yang YM, Cepeda M, Price C, Shah A, Mankad V: Depression in children and adolescents with sickle cell disease. Arch Pediatrics Adolescents Med 1994, 148:457-60.
• [12]Alao AO, Cooley E: Depression and sickle cell disease. Harvard Rev Psychiatry 2001, 9:169-77.
• [13]Wethers D: Sickle cell disease in childhood: part II. Diagnosis and treatment of major complications and recent advances in treatment. Am Fam Physician 2000, 62:1309-14.
• [14]Ramsey LT, Woods KF, Callahan LA, Menash GA, Barbeau P, Gutin B: Quality of life improvement for patients with sickle cell disease. Am J Hematol 2001, 66:155-6.
• [15]Palermo TM, Schwartz L, Drotar D, McGowan K: Parental report of Health-related quality of life in children with sickle cell disease. J Behav Med 2002, 25:269-83.
• [16]Compas B, Slavin L, Wagner B, Vannatta K: Relationship of life events and social support with psychological dysfunction among adolescents. J Youth Adolescence 1986, 15:727-35.
• [17]East P, Hess L, Lerner R: Peer social support and adjustment of early adolescent peer groups. J Early Adolescence 1987, 7:153-63.
• [18]Hoffman MA, Ushpiz V, Levy-Shift R: Social support and self-esteem in adolescents. J Youth Adolescence 1988, 17:307-16.
• [19]Nash KB, Kramer KD: Self-help for sickle cell disease in African American communities. J Applied Behav Sci 1993, 29:202-15.
• [20]Kovacs M: The Children’s Depression Inventory (CDI). Psychopharmacol Bull 1985, 21:995-8.
• [21]Twenge JM, Nolen-Hoeksema S: Age, gender, race, socioeconomic status, and birth cohort differences on the children’s depression inventory: a meta-analysis. J Abnorm Psychol 2002, 111:578-88.
• [22]Kovacs M: The Children’s Depression Inventory (CDI). Manual. Multi-Health Systems, North Tonawanda, NY; 1992.
• [23]Kovacs M: The Children’s Depression Inventory (CDI). Technical Manual Update. Multi-Health Systems, North Tonawanda, NY; 2003.
• [24]Shemesh E, Yehuda R, Rockmore L, Shneider BL, Emre S, Bartell AS, et al.: Assessment of depression in medically ill children presenting to pediatric specialty clinics. J Am Acad Child Adolesc Psychiatry 2005, 44:1249-57.
• [25]Allgaier AK, Fruhe B, Pietsch K, Saravo B, Baethmann M, Schulte-Korne G: Is the children’s depression inventory short version a valid screening tool in pediatric care? A comparison to its full-length version. J Psychosom Res 2012, 73:369-74.
• [26]Kovacs M: The Children’s Depression Inventory Parent Version (CDI-P). Multi-Health systems, Inc, Toronto; 1997.
• [27]Wierzbicki M: A parent form of the children’s depression inventory: reliability and validity in nonclinical populations. J Clin Psychol 1987, 43:390-7.
• [28]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, 39:28-38.
• [29]Shaffer D, Restifo K, Garfinkle R, Gould M, Lucas C: One- and Two-Stage Screens as Long-Term Predictors of Mood Disorders and Suicidality. Poster presented at the Annual Meeting of the American Academy of Child and Adolescent Psychiatry, Anaheim, CA; 1998.
• [30]Hinshaw SP, March JS, Abikoff H, Arnold LE, Cantwell DP, Conners CK, et al.: Comprehensive assessment of childhood attention-deficit hyperactivity disorder in the context of a multisite, multimodal clinical trial. J Attention Disord 1997, 1:217-34.
• [31]Varni JW, Seid M, The RCA, Peds QLTM: Measurement model for the pediatric quality of life inventory. Med Care 1999, 37:126-39.
• [32]Varni JW, Seid M, Peds KPS: QLTM: 4.0 reliability and validity of the pediatric quality of life inventory™ version 4.0 generic core scales in healthy and patient populations. Med Care 2001, 39:800-12.
• [33]McClellan CB, Schatz J, Sanchez C, Roberts CW: Validity of the pediatric quality of life inventory for youth with sickle cell disease. J Pediatr Psychol 2008, 33:1153-62.
• [34]Malecki CK, Demaray MK: Measuring perceived social support: development of the child and adolescent social support scale (CASSS). Psychol Sch 2002, 39:1-18.
• [35]Malecki CK, Demaray MK: Social support as a buffer in the relationship between socioeconomic status and academic performance. Sch Psychol Q 2006, 21:375-95.
• [36]Gresham F, Elliott S: The Social Skills Rating System. American Guidance Service, Circle Pines, MN; 1990.
• [37]Gresham F, Elliott S, Evans-Fernandez S: Student Self-Concept Scale. American Guidance Service, Circle Pines, MN; 1993.
• [38]Rucknagel DL: The genetics of sickle anemia and related syndromes. Arch Intern Med 1974, 133:595-606.
• [39]Gil KM, Abrams MR, Phillips G, Keefe FJ: Sickle cell disease pain: relation of coping strategies to adjustment. J Consult Clin Psychol 1989, 60:725-31.
• [40]Gil KM, Abrams MR, Phillips G, Williams DA: Sickle cell disease pain, II: predicting health care use and activity level at nine-month follow up. J Consult Clin Psychol 1992, 60:267-73.
• [41]Thompson RJ, Gil KM, Gustafson KE, George LK, Keith BR, Spock A, et al.: Stability and change in the psychological adjustment of mothers of children and adolescents with cystic fibrosis and sickle cell disease. J Pediatr Psychol 1994, 19:171-88.
• [42]Lewis HA, Kliewer W: Hope, coping and adjustment among children with sickle cell disease: tests of mediator and moderator models. J Pediatr Psychol 1996, 21:25-41.
• [43]Morgan SA, Jackson J: Psychological and social concomitants of sickle cell anemia in adolescents. J Pediatr Psychol 1986, 11:429-39.
• [44]Noll RB, Reiter-Purtill J, Vannatta K, Gerhardt CA, Short A: Peer relationships and emotional-wellbeing of children with sickle cell disease: a controlled replication. Child Neuropsychol 2007, 13:173-87.
• [45]Panepinto JA, O’Maher KM, DeBaun MR, Loberiza FR, Scott JP: Health-related quality of life in children with sickle cell disease and parent perception. Br J Haematol 2005, 130:437-44.
• [46]Panepinto JA, Pajewski NM, Foerster LM, Sabins S, Hoffman RG: Impact of family income and sickle cell disease on health-related quality of life of children. Qual Life Res 2008, 18:5-13.
• [47]Dale JC, Cochran CJ, Roy L, Jernigan E, Buchanan GR: Health-related quality of life in children and adolescents with sickle cell disease. J Pediatr Health Care 2011, 25:208-15.
• [48]Serjeant GR: The clinical features of sickle cell disease. Baillieres Clin Hematol 1993, 6:93-115.
• [49]Thomas VJ, Taylor LM: The psychological experience of people with sickle cell disease and it’s impact on quality of life: qualitative findings of a focus group. Br J Health Psychol 2002, 7:345-63.
• [50]Gil KM, Carson JW, Porter LS, Ready J, Valrie C, Redding-Lallinger R, et al.: Daily stress and mood and their association with pain, health-care use, and school activity in adolescents with sickle cell disease. J Pediatr Psychol 2003, 28:363-73.
• [51]Brooks R: Children at risk: fostering resilience and hope. Am J Orthopsychiatry 1994, 64:545-53.
• [52]Rak CF, Patterson LE: Promoting resilience in at-risk children. J Couns Dev 1996, 74:368-73.
• [53]Vichinsky EP, Johanson R, Lubin BH: Multidisciplinary approach to pain management in sickle cell disease. Am J Pediatric Hematol/Oncol 1982, 4:328-33.