[Speech impaired children. Anxiety, depression and quality of life of the mothers].
BACKGROUND
It is widely held that the well being of a mother significantly influences the way she brings up her child: Mothers with depression speak less to their child than healthy mothers do and so their emotional disorder has to be regarded an important cofactor for their child's speech development. On the other hand it is suspected that a mother's well being and quality of life may be influenced by her child especially in cases when the child suffers from impairment or developmental disturbance. As literature provides only little information on this topic the purpose of this study was to estimate both health related quality of life HRQOL and distinctive emotional reactions i.e. depression and anxiety in mothers of children with a speech developmental disorder.


METHODS
100 mothers (age 33.4+/-5.3 years, range: 22 to 47 years) of 100 preschool children (32 girls, 68 boys; age 4.2+/-1.5 years, range 1;3 to 7;7 years) with a speech impairment were investigated. Mothers of children with cochlear hearing loss, syndromes or other developmental disorders were excluded from the study. To estimate the prevalence of anxiety disorders and depression in the mothers the German version of the Hospital Anxiety and Depression Scale (HADS) was used. Data from 157 healthy women from the German test manual served as controls. HRQOL was assessed by the SF-36 questionnaire with age matched normal controls taken from the German test manual. Microsoft((R)) Excel and Matlab((R)) software packages were used for description, analysis, and evaluation. The differences in prevalence rates were tested by chi(2)-test and Wilcoxon's rank sum test.


RESULTS
Assessed by the HADS-depression subscale 11% of the mothers of speech impaired children met criteria for depression compared to 2.5% in the control group. The prevalence in the study group was significantly higher ( p<0.01). The prevalence of anxiety disorders did not differ from normative data on a significant level ( p>5%). The SF-36 questionnaire revealed lower scores of most SF-36 subscales on different significance levels. The results of both tests correlated on a statistically significant level.


CONCLUSIONS
Screening mothers of speech impaired children for a "soft" parameter like HRQOL and for epidemiologically relevant emotional disorders like depression and anxiety is of significant clinical interest. The SF-36 and the HADS are suitable tests. As the results of both tests are highly correlated for clinical purposes it seems reasonable to focus on depression and anxiety only. Up to now no data exist about how fathers of speech impaired children react emotionally, so this question has to be focused on in future. Although data allow no conclusion on whether the speech impairment is the reason or the consequence of a reduced HRQOL or an emotional disorder the results clearly indicate the necessity to take into account the mothers' well being when dealing with speech impaired children.
Rudolph
M
M
Abteilung für Phoniatrie und Pädaudiologie des Universitätsklinikum Erlangen, Erlangen.
Kummer
P
P
Eysholdt
U
U
Rosanowski
F
F
D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013064:Speech Disorders / Q000453:epidemiology* / Q000523:psychology*