title: Paediatric non-alcoholic Fatty liver disease: impact on patients and mothers' quality of life.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is one of the causes of fatty liver in adults and is currently the primary form of chronic liver disease in children and adolescents. However, the psychological outcome (i.e. the behavioural problems that can in turn be related to psychiatric conditions, like anxiety and mood disorders, or lower quality of life) in children and adolescents suffering of NAFLD has not been extensively explored in the literature.
  
  
  OBJECTIVE
  The present study aims at evaluating the emotional and behavioural profile in children suffering from NAFLD and the quality of life in their mothers.
  
  
  METHODS
  A total of 57 children (18 females/39 males) with NAFLD were compared to 39 age-matched control children (25 females/14 males). All participants were submitted to the following psychological tools to assess behavior, mood, and anxiety: the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Children's Depression Inventory (CDI). Moreover, the mothers of 40 NAFLD and 39 control children completed the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire.
  
  
  RESULTS
  NAFLD children scored significantly higher as compared to control children in MASC (P = 0.001) and CDI total (P < 0.001) scales. The CBCL also revealed significantly higher scores for NAFLD children in total problems (P = 0.046), internalizing symptoms (P = 0.000) and somatic complaints (P < 0.001). The WHOQOL-BREF revealed significantly lower scores for the mothers of NAFLD children in the overall perception of the quality of life (P < 0.001), and in the "relationships" domain (P = 0.023).
  
  
  CONCLUSIONS
  Increased emotional and behavioural problems were detected in children with NAFLD as compared to healthy control children, together with an overall decrease in their mothers' quality of life. These results support the idea that these patients may benefit from a psychological intervention, ideally involving both children and parents, whose quality of life is likely negatively affected by this disease.
authors.affiliation: Department of Neuroscience, Child Neuropsychiatry Unit, IRCCS Children's Hospital Bambino Gesù, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Mazzone
authors.forename: Valentina
authors.initials: V
authors.lastname: Postorino
authors.forename: Lavinia
authors.initials: L
authors.lastname: De Peppo
authors.forename: Claudia
authors.initials: C
authors.lastname: Della Corte
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lofino
authors.forename: Lia
authors.initials: L
authors.lastname: Vassena
authors.forename: Laura
authors.initials: L
authors.lastname: Fatta
authors.forename: Marco
authors.initials: M
authors.lastname: Armando
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bedogni
authors.forename: Stefano
authors.initials: S
authors.lastname: Vicari
authors.forename: Valerio
authors.initials: V
authors.lastname: Nobili
keywords: Adolescence; Anxiety; Children; Chronic Disease; Depression