Psychosocial implications of Thalassemia Major.
BACKGROUND
Many causes including the chronicity of disease, burden of treatment modalities, morbidities, and the expectation of early death resulting from the disease complications, may lead to psychosocial burden in Thalassemia Major (TM) patients.


METHODS
A total of 38 patients with TM and their mothers were recruited to evaluate the psychosocial burden as well as to disclose whether the psychological status of the patients contribute to the compliance with the therapy or to the contrary. Demographic and disease variables were obtained. Child Behavior Check-list (CBCL) was completed by the mothers of the patients. A detailed psychiatric interview based on the 4th edition of the Diagnostic and Statistical Manual diagnostic criteria was performed for each patient. Symptom Distress Checklist 90 (SCL-90) scale was given to all mothers for evaluating their psychopathology.


RESULTS
Although CBCL scores remained between the normal ranges, desferrioxamine mesylate (DFO)-compliant patients and the patients with lower ferritin values had significantly higher scores. A total of 24% of the patients had a psychiatric diagnosis including major depression, anxiety disorder, tic disorder, and enuresis nocturnal. The psychiatric diagnosis was significantly higher in the patients who were compliant with desferrioxamine compared with the non-compliant group (P = 0.007). The SCL-90 scores indicated that the mothers who had a child with good adherence to DFO had higher scale scores than the mothers with a poor adherent child.


CONCLUSIONS
The increase risk of psychosocial and behavioral problems in thalassemics and their parents indicated the importance of a lifelong psychosocial support for the prevention of mental health issues. The patients and their parents, who were more conscious of the illness, were more worried but more compliant with the therapy and need stronger psychiatric support.
Aydinok
Yesim
Y
Department of Pediatrics, Ege University Medical School, Izmir, Turkey. yaydin@med.ege.edu.tr
Erermis
Serpil
S
Bukusoglu
Nagihan
N
Yilmaz
Deniz
D
Solak
Ufuk
U
D001803:Blood Transfusion; D002648:Child; D002652:Child Behavior; D017281:Cost of Illness; D003676:Deferoxamine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007502:Iron Chelating Agents / Q000627:therapeutic use; D008297:Male; D009035:Mothers / Q000523:psychology; D010349:Patient Compliance; D012944:Social Support; D013315:Stress, Psychological; D017086:beta-Thalassemia / Q000523:psychology* / Q000628:therapy
D007502:Iron Chelating Agents; D003676:Deferoxamine