Fatigue, executive function and psychological effects in children with immune thrombocytopenia: a cross‐sectional study

Abstract

Childhood ITP is often considered to be a relatively mild haematological disorder, with only a minority of patients requiring treatment for troublesome bleeding. Over recent years, wider effects of the condition have been identified in some adults, particularly relating to fatigue and cognitive impairment. In this study, we sought to investigate such effects in a group of children with ITP and further our understanding of their psychological profile. Children attending routine haematology outpatient clinics and their parents were asked to complete standardised questionnaires designed to assess a range of psychological and cognitive factors. Although the majority of children had some scores within the normal range, a significantly high proportion had difficulties with fatigue (70Á6%), emotional and behavioural symptoms (25Á7%) or executive functioning (19Á4%). Quality of life and subjective evaluation of the illness (appraisal) correlated significantly with each of these domains, but bleeding severity and platelet count did not. Our findings provide valuable insight into the broader impact of childhood ITP, which could aid in providing holistic care, potentially contribute to decisions regarding medical treatment, and guide future research.

Fatigue perception in a cohort of children with chronic immune thrombocytopenia and their caregivers using the PedsQL MFS: Real‐life multicenter experience of the Italian Association of Pediatric Hematology and Oncology (AIEOP)

“…Defining the role of fatigue and its relationship with HRQoL in pediatric patients is essential for optimizing the ITP management. Towner et al reported fatigue in 70% of pediatric patients affected by ITP 20 . Subsequently, Grace et al confirmed these results 21 .…”

“…To date, few studies have explored fatigue and its relationship with chronic ITP in children and adolescents 20,21 . The aim of the present study is to determine fatigue perception in a large group of children with chronic ITP and their caregivers using PedsQL MFS, and to compare the results with those of healthy control subjects.…”

“…In several studies, fatigue is reported as an important clinical and psychological aspect for a significant number of children and adults affected by ITP 19–21 . To date, causes of fatigue in patients with ITP are not fully understood.…”

Risk Factors and Psychological Analysis of Chronic Immune Thrombocytopenia in Children

“…It is mostly manifested as prolonged disease course, recurrent attacks, and difficult treatment; 11,12 and CITP also has a certain impact on children's emotions, psychology, and behavior. 13 The Eysenck Personality Questionnaire (EPQ)-Children's version is divided into four dimensions: psychoticism (P), extraversion (E), neuroticism (N), and lying (L). It involves fewer concepts and is convenient to test.…”

“…Therefore, in addition to promoting the increase of platelet count, appropriate psychological intervention and adjustment are of great significance to the physical and mental health of children. 13 The application of long-term corticosteroids and immunosuppressive agents has serious adverse effects, which have a negative impact on children's physical and mental health, quality of life and family. 40 Physicians and children need reliable and instructive conclusions, which will help clinicians to effectively monitor and improve the outcome in the early treatment period, and reduce the impact of the disease on the children's daily life and psychology.…”