Beta talasemili ergenlerde sosyal, duygusal ve davranışsal güçlüklerin ve ebeveynlerinde psikopatolojinin değerlendirilmesi

GIRIŞ ve AMAC: Bu calismada, beta-globin sentezinde defekt nedeniyle ortaya cikan azalmis eritrosit sentezi, anemi ve demir birikimiyle karakterize kalitsal bir kronik hastalik olan beta-talasemili ergenlerde sosyal, duygusal ve davranissal gucluklerin ve ebeveynlerinde psikopatoloji yayginliginin degerlendirilmesi amaclanmistir.  YONTEM ve GERECLER: 24 Beta-talasemili ergen ve ulasilabilen ebeveyn hasta grubu; daha once fiziksel ve mental hastalik oykusu bulunmayan, yas ve cinsiyet acisindan eslestirilmis 20 ergen ve ulasilabilen ebeveyn de kontrol grubu olarak calismaya dahil edilmistir. Ergenlerde islevsellik Gucler-Guclukler Anketi (GGA) ile degerlendirilmistir. Ebeveynlerde psikopatolojiyi degerlendirmek icin 90 itemlik bir ozbildirim olcegi olan Ruhsal Belirti Tarama Listesi 90-R (RBTL 90-R) kullanilmistir. BULGULAR: Talasemili ergenlerde GGA yasit iliskileri, emosyonel semptomlar ve total gucluk subskorlari, bu alanlarda soruna isaret eder sekilde anlamli olarak daha yuksek bulundu. Ebeveynlerde, hasta grubunda yuksek cikan obsesif-kompulsif skalasi haric, tum RBTL 90-R alt skorlari ve genel semptom indeks skoru her iki grupta normal sinirlarda olsa da, ailede ikinci bir talasemili cocuk varligi ile ebeveynlerde anksiyete duzeyi arasinda anlamli bir iliski saptandi. Benzer sekilde, cocukta dismorfi varliginda tum alt skorlar ve genel semptom indeksi skoru anlamli olarak artmaktaydi. Ancak cocukta talasemi komplikasyon(lar)inin varligi ile benzer bir korelasyon saptanmadi. TARTIŞMA ve SONUC: Hastaligin kronik ve olumcul olusu, tedaviye bagli zorluklar ve demir birikimine bagli ortaya cikan ikincil rahatsizliklar nedeniyle hasta cocukta ve ebeveynlerde psikolojik ve sosyal sorunlar gorulebilmektedir. Bu nedenle tibbi tedavinin psikososyal destekle kombine edilmesi, cocuk-aileyi bir butun olarak ele almak ve olasi psikopatolojilerin tanisi ve tedavisi bir gerekliliktir. The social, emotional and behavioral difficulties in thalassemic adolescents and psychopathology in their parents Asli Surer Adanir 1 ,  Gulseren Taskiran 2 ,  Cem Koparan 2 ,  Esin Ozatalay 1 1 Akdeniz University School Of Medicine, Department Of Child And Adolescent Psychiatry, Antalya 2 Antalya Training And Research Hospital, Department Of Child And Adolescent Psychiatry, Antalya INTRODUCTION: The aim of this study is to investigate the social, emotional and behavioral difficulties in adolescents and the prevalance of pyschopatology in parents of adolescents with βeta-thalassemia, a chronic disease which is a hereditary blood disorder characterized by reduced or absent beta globin chain synthesis, resulting in decreased red blood cell production, anemia and subsequent secondary diseases as a result of iron loading. METHODS: For this aim, 24 adolescents with Beta-thalassemia and accessible parent, as the study group and 20 adolescents without any physical or mental problems and accessible parent, as the control group were recruited. Functionality of adolescents was assessed with Strengths and Difficulties Questionnaire (SDQ) and psychopatology in parents was assessed with The Symptom Checklist 90-R (SCL 90-R), a self-report questionnaire consisting of 90 items. RESULTS: In thalassemic adolescents, SDQ subscores in peer relations, emotional symptoms and total difficulties were significantly higher, indicating problems in these areas. In both groups, all SCL 90-R subscale scores and general symptom index score were in normal range, but obsessive-compulsive score was statistically higher in thalassemia group. There was a significant correlation between the anxiety subscores of parents and presence of dismorfism in the thalassemic child. The presence of a second child with thalassemia in the family also correlated with the overall psychopathology in parents. But contrary to expectation, in the presence of thalassemia complication(s), no correlation was found. DISCUSSION AND CONCLUSION: Because of the the chronic and fatal nature of the disease, difficulties about the treatment and secondary diseases due to the iron overload, psychological and social problems can be seen in the patients and their parents. In this respect, it’s a necessity to combine the medical treatment with psychosocial support, handle the child and the family as a whole and ensure the identification and treatment of any possible psychopathologies. Keywords:  Chronic disease, Beta-Thalassemia, adolescent, parents, psychosocial difficulties, psychopathology