Psychological outcome and quality of life in children born with congenital diaphragmatic hernia.
OBJECTIVE
To assess psychological and social functioning and health related quality of life and its early determinants in children born with congenital diaphragmatic hernia (CDH).


METHODS
Cross-sectional follow-up study.


METHODS
Outpatient clinic of a tertiary care hospital.


METHODS
33 CDH survivors aged 6-16 years.


METHODS
Patients who developed CDH associated respiratory distress within 24 h after birth.


METHODS
Psychological and social functioning assessed with the Wechsler Intelligence Scale for Children (WISC-R), Bourdon-Vos test, Beery Developmental Test of Visual Motor Integration, Child Behavior Checklist (CBCL) and Teacher Report Form (TRF), and health related quality of life assessed with the Child Health Questionnaire (CHQ) and Health Utilities Index (HUI).


RESULTS
Normal mean (SD) total IQ (100.0 (13.2)) and normal visual-motor integration, but significantly lower results for sustained attention (Bourdon-Vos test, 38.8 (11.2) points) were found. Learning difficulties were reported by 30% of parents. Eight children had scores in the clinical range on the CBCL and/or TRF, indicating clinically significant behavioural problems. Except for the CHQ scale General Health, health status was not different from the reference population. No significant correlations between test results and severity of CDH were found, except for an association of general health and physical functioning with length of hospital stay.


CONCLUSIONS
CDH patients are at risk for subtle cognitive and behavioural problems, probably not related to CDH severity. Perception of general health is reduced compared to the reference population, indicating that CDH survivors and their parents believe their health is poor and likely to get worse.
Peetsold
M G
MG
Department of Pediatrics, VU University Medical Centre, 1007 MB Amsterdam, The Netherlands. m.peetsold@vumc.nl
Huisman
J
J
Hofman
V E
VE
Heij
H A
HA
Raat
H
H
Gemke
R J
RJ
D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006548:Hernia, Diaphragmatic / Q000453:epidemiology / Q000523:psychology*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests; D011788:Quality of Life; D012649:Self Concept; D012919:Social Behavior