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Psychological Profile of Children Who Require Repetitive Surgical Procedures for Early Onset Scoliosis: Is a Poorer Quality of Life the Cost of a Straighter Spine?

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Abstract

Study Design

Cross-sectional study.

Objective

Assess the psychosocial status of children with early-onset scoliosis (EOS) undergoing multiple procedures and evaluate associations with other variables.

Summary of Background Data

EOS may require repetitive surgical procedures to control deformity and preserve growth. These procedures impact patients’ psychosocial status because of the repetitive surgeries.

Methods

EOS patients 6–18 years, undergoing traditional growing rod treatment with more than 5 surgical procedures, and neurologically/mentally intact were included. Patients were screened for psychiatric disorders before inclusion. The Quality of Life Scale for Children (PedsQL), Strengths and Difficulties Questionnaire (SDQ) self-report form, Beck Depression Inventory, Children Depression Inventory (CDI), Beck Anxiety Inventory (BAI), and the Self-Report for Childhood Anxiety Related Disorders (SCARED) were completed by the children. PedsQL Parental Form and SDQ Parent Form were completed by their parents.

Results

Twenty-one patients (9 male, 12 female) met the inclusion criteria. Average age was 6.4 years (4–10.5) at index surgery, and 13.5 years (8–17) at final follow-up. The mean number of procedures was 13 (6–18). Mean follow-up was 83.9 months (36–122). Depression was observed in 23.8% of patients, and generalized anxiety disorder in 42.8%. Patients in the study group were more likely than the general population to have a psychiatric diagnosis. Number of procedures undergone was found to correlate negatively with BAI, SCARED, and the behavioral difficulties domain of SDQ parent form score and positively with emotional functioning, psychosocial health summary score, PedsQL total score, and increased social and physical functioning. Nonidiopathic etiology was found to be related to increased behavioral difficulties and lower functioning.

Conclusion

A higher prevalence of depressive and anxiety symptoms was observed in patients with EOS along with dysfunctional areas of daily life. Other comorbidities may also contribute to dysfunction and difficulties. Determination of the aspects of EOS treatment that have a negative impact on psychosocial functioning may allow for more competent help for these patients.

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References

  1. Cheung KM-C, Cheung JP-Y, Samartzis D, et al. Magnetically controlled growing rods for severe spinal curvature in young children: a prospective case series. Lancet 2012;379:1967–74.

    Article  Google Scholar 

  2. Akbarnia BA, Cheung K, Noordeen H, et al. Next generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients with early-onset scoliosis. Spine 2013;38:665–70.

    Article  Google Scholar 

  3. Akbarnia BA, Breakwell LM, Marks DS, et al. Dual growing rod technique followed for three to eleven years until final fusion: the effect of frequency of lengthening. Spine 2008;33:984–90.

    Article  Google Scholar 

  4. Akbarnia BA, Marks DS, Boachie-Adjei O, et al. Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine 2005;30(17 Suppl):S46–57.

    Article  Google Scholar 

  5. Flynn JM, Tomlinson LA, Pawelek J, et al. Growing-rod graduates: lessons learned from ninety-nine patients who completed lengthening. J Bone Joint Surg Am 2013;95:1745–50.

    Article  Google Scholar 

  6. Flynn JM, Matsumoto H, Torres F, et al. Psychological dysfunction in children who require repetitive surgery for early onset scoliosis. J Pediatr Orthop 2012;32:594–9.

    Article  Google Scholar 

  7. Matsumoto H, Williams BA, Corona J, et al. Psychosocial effects of repetitive surgeries in children with early-onset scoliosis: are we putting them at risk? J Pediatr Orthop 2014;34:172–8.

    PubMed  Google Scholar 

  8. Kaufman J, Birmaher B, Brent D, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980–8.

    Article  CAS  Google Scholar 

  9. Gökler B, Ünal F, Pehlivantürk B, et al. Reliability and validity of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T). Turkish J Child Adolesc Ment Health 2004;11:109–16.

    Google Scholar 

  10. Varni JW, Seid M, Rode CA. The PedsQL: measurement model for the pediatric quality of life inventory. Med Care 1999;37:126–39.

    Article  CAS  Google Scholar 

  11. Uneri OS, Agaoglu B, Coskun A, Memik NC. Validity and reliability of Pediatric Quality of Life Inventory for 2- to 4-year-old and 5- to 7-year-old Turkish children. Qual Life Res 2008;17:307–15.

    Article  Google Scholar 

  12. Memik NÇ, Ağaoğlu B, Coşkun A, Uneri OS. The validity and reliability of the Turkish Pediatric Quality of Life Inventory for children 13–18 years old. Turkish J Psychiatry 2007;18:353–63.

    Google Scholar 

  13. Memik NÇ, Ağaoğlu B, Coşkun A, Karakaya I. The validity and reliability of Pediatric Quality of Life Inventory in 8–12 year old Turkish children. Turkish J Child Adolesc Ment Health 2008;15:87–98.

    Google Scholar 

  14. Wechsler D. Manual for the Wechsler Intelligence Scale for Children, revised. San Antonio, TX: The Psychological Corporation; 1974.

    Google Scholar 

  15. Savaşır I, Şahin N. Manual for the Wechsler Intelligence Scale for Children—revised (WISC-R). Ankara, Turkey: Turkish Psychology Association Publication; 1995.

    Google Scholar 

  16. Kovacs M. The Children’s Depression, Inventory (CDI). Psychopharmacol Bull 1985;21:995–8.

    CAS  PubMed  Google Scholar 

  17. Oy B. Cocuklar icin depresyon olcegi: Gecerlik ve guvenirlik calismasi. Turk Psikiyatri Dergisi 1991;2(2):132–6.

    Google Scholar 

  18. Goodman R, Meltzer H, Bailey V. The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Int Rev Psychiatry 2003;15:173–7.

    Article  CAS  Google Scholar 

  19. Güvenir T, Özbek A, Baykara B, et al. Psychometric properties of the Turkish version of the Strengths and Difficulties Questionnaire (SDQ). Turkish J Child Adolesc Ment Health 2008;15:65–74.

    Google Scholar 

  20. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893–7.

    Article  CAS  Google Scholar 

  21. Hisli N. A study on the validity of Beck Depression Inventory. Turkish J Psychol 1988;6:118–22.

    Google Scholar 

  22. Hisli N. Beck Depression Inventory: The validity and reliability study for university students. J Psychol 1989;7:3–13.

    Google Scholar 

  23. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother 1998;12:153–62.

    Google Scholar 

  24. Birmaher B, Khetarpal S, Brent D, et al. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 1997;36:545–53.

    Article  CAS  Google Scholar 

  25. Karaceylan Çakmakçı F. Çocuklarda Anksiyete Bozukluklarını Tarama Ölçeğ geçerlik ve güvenirlik çalışması. Unpublished Expertise Thesis, Department of Child and Adolescent Psychiatry. Kocaeli: Kocaeli University, Faculty of Medicine; 2004.

    Google Scholar 

  26. Costello EJ, Mustillo S, Erkanli A, et al. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003;60:837–44.

    Article  Google Scholar 

  27. March JS. Anxiety disorders in children and adolescents. New York: Guilford Press; 1995. p. 1.

    Google Scholar 

  28. Kessler RC, Avenevoli S, Costello EJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 2012;69:372–80.

    Article  Google Scholar 

  29. Kassam-Adams N, Winston FK. Predicting child PTSD: the relationship between acute stress disorder and PTSD in injured children. J Am Acad Child Adolesc Psychiatry 2004;43:403–11.

    Article  Google Scholar 

  30. Bryant RA, Salmon K, Sinclair E, Davidson P. The relationship between acute stress disorder and posttraumatic stress disorder in injured children. J Trauma Stress 2007;20:1075–9.

    Article  Google Scholar 

  31. Dalgleish T, Meiser-Stedman R, Kassam-Adams N, et al. Predictive validity of acute stress disorder in children and adolescents. Br J Psychiatry 2008;192:392–3.

    Article  Google Scholar 

  32. Maughan B, Rowe R, Messer J, et al. Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. J Child Psychol Psychiatry 2004;45:609–21.

    Article  Google Scholar 

  33. Caldas JCS, Pais-Ribeiro JL, Carneiro SR. General anesthesia, surgery and hospitalization in children and their effects upon cognitive, academic, emotional and sociobehavioral development—a review. Paediatr Anaesth 2004;14:910–5.

    Article  Google Scholar 

  34. Butler RW, Rizzi LP, Handwerger BA. Brief report: the assessment of posttraumatic stress disorder in pediatric cancer patients and survivors. J Pediatr Psychol 1996;21:499–504.

    Article  CAS  Google Scholar 

  35. Schwering KL, Febo-Mandl F, Finkenauer C, et al. Psychological and social adjustment after pediatric liver transplantation as a function of age at surgery and of time elapsed since transplantation. Pediatr Transplant 1997;1:138–45.

    CAS  PubMed  Google Scholar 

  36. Kain ZN, Mayes LC, O’Connor TZ, Cicchetti DV. Preoperative anxiety in children. Predictors and outcomes. Arch Pediatr Adolesc Med 1996;150:1238–45.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Mental Health, Hacettepe University School of Medicine, Ankara, Turkey

    Cihan Aslan MD, Seniz Ozusta PhD & Fatih Unal MD

  2. University Orthopaedics PC, 19 Bradhurst Ave #1300, Hawthorne, NY, 10532, USA

    Z. Deniz Olgun MD

  3. Department of Orthopaedics and Traumatology, Hacettepe University School of Medicine, Ankara, Turkey

    Erkan Sabri Ertas MD, Gokhan Demirkiran MD & Muharrem Yazici MD

Authors
  1. Cihan Aslan MD
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  2. Z. Deniz Olgun MD
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  3. Erkan Sabri Ertas MD
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  4. Seniz Ozusta PhD
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  5. Gokhan Demirkiran MD
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  6. Fatih Unal MD
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  7. Muharrem Yazici MD
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Correspondence to Muharrem Yazici MD.

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Aslan, C., Olgun, Z.D., Ertas, E.S. et al. Psychological Profile of Children Who Require Repetitive Surgical Procedures for Early Onset Scoliosis: Is a Poorer Quality of Life the Cost of a Straighter Spine?. Spine Deform 5, 334–341 (2017). https://doi.org/10.1016/j.jspd.2017.03.007

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  • DOI: https://doi.org/10.1016/j.jspd.2017.03.007

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