High and intermediate imperforate anus: psychosocial consequences among school-aged children.
OBJECTIVE
Imperforate anus is an unusual malformation, which, even after surgical intervention, usually entails constipation and fecal incontinence. This study aimed to evaluate ongoing psychosocial effects of this birth defect in school-aged children.


METHODS
Twenty-five children born with high and intermediate imperforate anus participated in the study, along with their parents and classroom teachers. One group of healthy children and 1 group of children with juvenile chronic arthritis, along with their parents, served as controls. Children and parents individually answered a questionnaire devised for this study. Parents filled out the Child Behavior Checklist and the children's teacher filled out the Teacher's Report Form.


RESULTS
According to test results, children with imperforate anus were happy and optimistic. They liked school better and reported better relationships with schoolmates than the other children. The index group reported statistically significantly more frequent constipation. According to parental responses, the imperforate-anus children suffered from fecal incontinence and odor, as well as constipation (P < .001). Index-group parents reported on the Child Behavior Checklist that their children had more emotional and behavioral problems. On the Teacher's Report Form, teachers reported few problems for the same children.


CONCLUSIONS
Patients with imperforate anus did not experience psychosocial impairment despite significant functional problems.
Ojmyr-Joelsson
Maria
M
Division of Pediatric Surgery, Q2:03, Astrid Lindgren Children's Hospital, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. maria.ojmyr-joelsson@karolinska.se
Nisell
Margret
M
Frenckner
Björn
B
Rydelius
Per-Anders
PA
Christensson
Kyllike
K
D000223:Adaptation, Psychological; D000293:Adolescent; D000367:Age Factors; D001006:Anus, Imperforate / Q000145:classification / Q000523:psychology* / Q000601:surgery; D002648:Child; D003248:Constipation / Q000209:etiology / Q000523:psychology*; D005178:Faculty; D005242:Fecal Incontinence / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012647:Self-Assessment; D011795:Surveys and Questionnaires