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Predictors of anxiety and depression in Egyptian thalassemic patients: A single center study

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Abstract

Thalassemic patients are vulnerable to emotional and behavioral problems. Each patient age group exhibits problems unique to that stage of development, and although up to 80 % of thalassemic patients are likely to have psychological disorders, e.g., anxiety and depression, predictors of these disorders remain poorly understood. The present study was designed to assess the prevalence of anxiety and depression in a sample of Egyptian thalassemic patients and to identify predictors of these psychiatric disorders. A case–control study was conducted in 218 thalassemic patients, with 244 healthy subjects as a control. All patients and control subjects were subjected to thorough evaluation of medical history and clinical examination, and examined by a psychiatrist using the clinician version of the structured clinical interview for DSM-IV (SCID-CV), hospital anxiety and depression scale and Coopersmith self-esteem inventory. Abnormal and borderline anxieties were reported by 36.7 and 20.6 % of thalassemic patients, respectively, while abnormal and borderline depressions were reported by 32.1 and 16.1 % of patients, respectively. Hospitalization, low self-esteem, diabetes mellitus and heart failure were independent predictors of anxiety. The independent predictors of depression were heart failure, hospitalization, diabetes mellitus, short stature and delayed puberty. Thalassemic patients were more vulnerable to anxiety and depression, indicating that screening and management for such psychiatric disorders should be considered in treating all such patients.

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References

  1. Chapman DP, Perry GS, Strine TW. The vital link between chronic disease and depressive disorders. Prev Chronic Dis [serial online] 2005 Jan [date cited]. http://www.cdc.gov/pcd/issues/2005/jan/04_0066.htm.

  2. Beratis S. Psychosocial status in pre-adolescent children with beta-thalassemia. J Psychosom Res. 1993;37(3):271–9.

    Article  PubMed  CAS  Google Scholar 

  3. Sadowski H, Kolvin I, Clemente C, Tsiantis J, Baharaki S, Ba G. Psychopathology in children from families with blood disorders: a cross-national study. Eur Child Adolesc Psychiatry. 2002;11:151–61.

    Article  PubMed  Google Scholar 

  4. Shaligram D, Girimaji SC, Chaturvdi SK. Psychological problems and quality of life in children with thalassemia. Indian J Pediatr. 2007;74:727–30.

    Article  CAS  Google Scholar 

  5. Pradhan PV, Shah H, Rao P, Ashturkar D, Ghaisas P. Psychopathology and self-esteem in chronic illness. Indian J Pediatr. 2003;70(2):135–8.

    Article  PubMed  Google Scholar 

  6. Tsiantis J, Dragonas Th, Richardson C, Anastasopoulos D, Masera G, Spinetta J. Psychosocial problems and adjustment of children with beta-thalassemia and their families. Eur Child Adolesc Psychiatry. 1996;5(4):193–203.

    Article  PubMed  CAS  Google Scholar 

  7. Mikelli A, Tsiantis J. Brief report: depressive symptoms and quality of life in adolescents with thalassemia. J Adolesc. 2004;27:23–216.

    Article  Google Scholar 

  8. Messina G, Colombo E, Ferri F, Curti R, Altamura C, Cappellini MD. Psychosocial aspects and psychiatric disorders in young adult with thalassemia major. Intern Emerg Med. 2008;3:339–43.

    Article  PubMed  Google Scholar 

  9. Ghanizadeh A, Sirin K, Hamid A. Prevalence of psychiatric disorders, depression and suicidal behavior in child and adolescent with thalassemia major. J Pediatr Hematol Oncol. 2006;28:781–4.

    Article  PubMed  Google Scholar 

  10. Fahmy S, El-Sherbini AF. Determining simple parameters for social classifications for health research. Bull High Inst Public Health. 1983;13:95–108.

    Google Scholar 

  11. First MB, Spitzer RL, Gibbon M, Williams, Janet BW. Structured clinical interview for DSM-IV Axis I disorders, Clinician Version (SCID-CV). Washington, D.C.: American Psychiatric Press, Inc., 1996.

  12. American Psychiatric Association : Diagnostic and statistical manual of mental disorders. 4th ed, text rev. Washington, DC: American Psychiatric Association, 2000.

  13. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.

    Article  PubMed  CAS  Google Scholar 

  14. EL-Rufaie OE, Absood GH. Retesting the validity of the Arabic version of the Hospital Anxiety and Depression (HAD) scale in primary health care. Soc Psychiatr Epidemiol. 1995;30:26–31.

    Article  CAS  Google Scholar 

  15. White D, Leach C, Sims R, Atkinson M, Cottrell D. Validation of the hospital anxiety and depression scale for use with adolescents. Br J Psychiatry. 1999;175:452–4. doi:10.1192/bjp.175.5.452.

    Article  CAS  Google Scholar 

  16. Chan Y-F, Leung DYP, Fong DYT, Leung C-M, Lee AM. Psychometric evaluation of the hospital anxiety and depression scale in a large community sample of adolescents in Hong Kong. Qual Life Res. 2010;19(6):865.

    Article  Google Scholar 

  17. Coopersmith S. Building Self-esteem in the classroom. In: Coopermith S, editor. Developing motivation in children. Palo Alto, California: Consulting Psychologists Press Inc.; 1975, p. 95–132.

  18. Mousa FA, Dosoky M. Arabic translation of Coopersmith S. Coopersmith Self-Esteem Inventory for children. Faculty of Education, Zakaazek University, Dar El-Nahda El-maseria. 1991.

  19. Becker KA. History of the Stanford-Binet intelligence scales: Content and psychometrics. (Stanford-Binet Intelligence Scales, Fifth Edition Assessment Service Bulletin No. 1). Itasca, IL: Riverside Publishing; 2003.

  20. Aydinok Y, Erermis S, Bukusoglu N, Yilmaz D, Solok U. Psychosocial implication of thalassemia major. Pediatr Int. 2005;47:84–9.

    Article  PubMed  Google Scholar 

  21. Ratip S, Skuse D, Porter J, Wonke B, Yardumian A, Modell B. Psychosocial and clinical burden of thalassaemia intermedia and its implications for prenatal diagnosis. Arch Dis Child. 1995;72:408–12.

    Article  PubMed  CAS  Google Scholar 

  22. Mednick L, Yu S, Trachtenberg F, et al. Symptoms of depression and anxiety in patients with thalassemia: prevalence and correlates in the thalassemia longitudinal cohort. Am J Haematol. 2010;85(10):802–5.

    Article  Google Scholar 

  23. Saravi VG, Zarghami M, Tirgari A, Ebrahimi E. Relationship between thalassemia and depression. Res J Biol Sci. 2007;2:280–4.

    Google Scholar 

  24. Moussa MA, Alsaeid M, Abdella N, Refai TM, Al Sheikh N, Gomez JE. Social and psychological characteristics of Kuwaiti children and adolescents with type 1 diabetes. Soc Sci Med. 2005;60:1835–44.

    Article  PubMed  CAS  Google Scholar 

  25. Sabry N, Salama KH. Cognitive abilities, mood changes and adaptive functioning in children with b thalassaemia. Curr Psychiatry. 2009;16:244–54.

    Google Scholar 

  26. Khurana A, Katyal S, Marwaha RK. Psychosocial burden in thalassemia. Indian J Pediatr. 2006;73:877–80.

    Article  PubMed  Google Scholar 

  27. Huurre TM, Aro HM. Long-term psychosocial effects of persistent chronic illness: a follow-up study of Finnish adolescents aged 16 to 32 years. Eur Child Adolesc Psychiatry. 2002;11:85–91.

    Article  PubMed  CAS  Google Scholar 

  28. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National comorbidity survey Replication (NCS-R). Arch Gen Psychiatry. 2005;62:617–27.

    Article  PubMed  Google Scholar 

  29. Collishaw S, Maughan B, Natarajan L, Pickle SA. Trends in adolescent emotional problems in England: a comparison of two national cohorts twenty years apart. J Child Psychol and Psyc. 2010;51:885–94.

    Article  Google Scholar 

  30. Hershko C, Link G, Cabantchik I. Pathophysiology of iron overload. Ann NY Acad Sci. 1998;850:191–201.

    Article  PubMed  CAS  Google Scholar 

  31. Blumberg BD, Lewis JM, Susman EJ. Adolescence: a time of transition. In: Eisenberg G, Sutkin LC, Jansen MA, editors. Chronic illness and disability through the life span: effects on self and family. New York: Springer; 1984.

    Google Scholar 

  32. Kellerman J, Zeltzer L, Ellenberg L, Dash J, Rigler D. Psychological effects of illness in adolescence. I. Anxiety, self-esteem, and perception of control. J Pediatr. 1980;97(1):126–31.

    Article  PubMed  CAS  Google Scholar 

  33. Gardner GG. Adolescents with cancer: current issues and proposals. J Pediatr Psychol. 1977;2(3):132–4.

    Article  Google Scholar 

  34. Georganda ET. The impact of thalassemia on body image, self image, and self-esteem. Ann NY Acad Sci. 1990;612:466–72.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Sohier Yahia.

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Yahia, S., El-Hadidy, M.A., El-Gilany, AH. et al. Predictors of anxiety and depression in Egyptian thalassemic patients: A single center study. Int J Hematol 97, 604–609 (2013). https://doi.org/10.1007/s12185-013-1322-z

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  • DOI: https://doi.org/10.1007/s12185-013-1322-z

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