Depression in children with thalassemia major: prevalence and contributing factors

Abstract

Background Thalassemia major is a chronic disease requiring lifetime treatment. A recent study showed that 11-62% of thalassemia patients developed depression, which is associated with high morbidity and mortality. Understanding the extent of the problem related to depression and its contributing factors is important for early management.
 Objective To determine the prevalence and contributing factors for depression in children with thalassemia major.
 Methods This cross-sectional observational analytic study included thalassemia major patients aged 7 to <18 years in the Department of Child Health, Dr. Moh. Hoesin General Hospital (RSMH) in Palembang from June to July 2018 and had received blood transfusions at least 3 times. Subjects completed the Children’s Depression Inventory (CDI) questionnaire. Depression was defined as a total score > 13. Data were analyzed using SPSS for Windows ver. 22.0.
 Results There were 64 patients included in this study, with mean age 12 (SD 3) years and 82.8% female. Most subjects came from families with low socio-economic status and low parental education. Deferiprone was the most commonly used type of iron-chelating agent. Depression was detected in 34.4% of respondents. Multivariate analysis revealed that factors affecting depression in children with thalassemia major were low maternal education (OR 4.014; 95%CI 1.066 to 15.112) and use of deferasirox (OR 4.129; 95%CI 1.168 to 14.601).
 Conclusion Prevalence of depression in children with thalassemia major is 34.4%. Low maternal education and deferasirox use as an iron-chelating agent are associated with depression in children with thalassemia major.

Determinant factors of depression in beta major thalassemia children

“…Children with thalassemia faced stressful effects throughout their lives, including frequent blood sampling for laboratory tests, frequency of transfusions and frequent subcutaneous injections and oral therapy of iron chelator drugs, all of which mad patients vulnerable to psychiatric loads such as depression and anxiety (Pattanashetti et al 2017). Venty's study showed no correlation between the frequency of blood transfusions, pre-transfusion hemoglobin levels and depression (Venty et al 2018). However, it was different from other studies which showed a correlation between the frequency of blood transfusion and depression.…”

“…Blood transfusion more often caused an increase in school absenteeism and affects patients interacting socially with their peers. Therefore, they felt isolated and vulnerable to depression (Venty et al 2018).…”

“…The same results were obtained in the study by Venty, that the duration of illness with an average value of 8 years (SD 4) did not find a significant relationship with depression. According to the study, the difference in his study was also influenced by genetic factors, social demographic factors, psychological factors, social factors and different types of questionnaires used in each study (Venty et al 2018). In contrast to previous studies by Khurana which explained that the longer the patient suffers from an illness, the higher degree of depression, because the longer patient got uncomfortable treatment from symptoms of persistent disease and actions during treatment (taking blood, repeated transfusion and continuing continuously) (Khurana et al 2006).…”

Physical wellness among adolescents with hemoglobinopathic disorders

“…Another study conducted by (Venty et al, 2018), on 64 thalassemic children aged 7_18 years, there finding the mean Hb level was 7.18 [26] .…”

Perbandingan Masalah Mental Emosional dan Karakteristik Pasien Remaja dengan Talasemia Mayor di Poli Talasemia RSUP Dr. Hasan Sadikin Bandung

“…Usia remaja yang rentan perubahan emosional juga dapat menjadi faktor pendukung masalah emosional tersebut. 9,14 Masalah kedua yang paling banyak dialami oleh pasien adalah masalah conduct dengan proporsi 12%. Jumlah ini hampir sama dengan proporsi pada penelitian Behdani dkk 13 yang menunjukkan proporsi masalah conduct 11,9%.…”