Psychological Aspects in Children and Adolescents with Major Thalassemia: A Case-Control Study

Abstract

Background:Thalassemia is an inherited blood disease. It is a serious public health problem throughout the Mediterranean region, the Middle East and the Indian subcontinent, as well as in Southeast Asia.Objectives:Thalassemia is an inherited blood disease. It is a serious public health problem. In this study we assessed psychological aspects in Iranian children and adolescents with thalassemia major.Patients and Methods:In this case-control study sixty healthy subjects aged 7-18 years and Sixty Patients with confirmed diagnosis of major thalassemia were enrolled. After obtaining informed consent from parents of all participating thalassemia patients and healthycontrols, we assessed psychological aspects and quality of life by Pediatric Quality of LifeTM (PedsQL™), Strengths and Difficulties Questionnaires (SDQ), State and Trait Anxiety, Children's Depression Inventory (CDI). Results:The results of this study indicate that there are significant changes in depression, anxiety, QOL and behavioral screening between children with thalassemia major compared with healthy subjects by means of both parents and children reports. According to the results, children with thalassemia major have more psychological problems than healthy ones. Patients with thalassemia have a lower QOL than their peers (P = 0.001), the rate of depression is higher in this group (P = 0.015), Also behavioral problems in these children are more than healthy subjects (P = 0.009).Conclusions:We recommend appropriate treatment and counseling procedures in addition to specific treatment of thalassemia. According to the results we suggest to establish pediatric psychiatric clinics beside thalassemic clinics to cure psychological aspects of the disease.

Coping Behaviors in Parents of Children with Thalassemia major

“…According to the findings of a study in Iran, 44% of the children affected by thalassemia major had anxiety and depression and 74% had a low quality of life (14). chological issues and lower quality of life in children with thalassemia major, compared to their other counterparts (8). However, more than 90% of these children continue their lives even possibly until their fourth decade, if they receive suitable cares (15).…”

“…Approximately 2 -3 million people are estimated to be carriers of beta-thalassemia and 25,000 patients exist in Iran (8). More than 2000 cases of beta-thalassemia major have been documented in Sistan and Baluchistan province (9).…”

The Depression Categories of Adolescent with Beta-Thalassemia Major

“…Baraz, Miladinia, & Mosavinouri (2016) stated that teenagers with thalassemia do not experience the development of adulthood like a healthy teenager, this is the difference between healthy adolescents and adolescent with thalassemia. According to Behdani et al (2015), depression in teenage children with thalassemia was around 26.7%, seen as significant compared to healthy. Tab1e 1, the number of male respondents was around 42.9% and women (57.1%).…”

“…The research conducted by Shaligram et al (2007), showed that 44% of thalassemia teenagers had psychological problems, including anxiety 67%, emotional problems, especially depression, 62% and behavioral problems 49%. Another study conducted by Behdani et al (2015), regarding depression in adolescents with thalassemia, showed that patients with thalassemia experienced depression of about 26.7%, significant discharge compared to healthy children. According to Pattanashetti et al (2017), the prevalence of depression in thalassemia reached 41.94% with the majority of them had mild depression.…”

Acceptance and Commitment Therapy Improves Psychological Flexibility of Students with Thalassemia Major: A Randomized Controlled Trial

“…Our comprehensive search shows that most psychological studies that conducted on patients with thalassemia have tried to assess different aspects of their mental properties (Behdani et al, 2015;Pattanashetti, Mugali, Pattanashetty, & Patil, 2017) but there are no psychological interventional studies on their problems with the ACT method. In the process of treatment by the ACT, psychological flexibility has introduced as the basis of psychological health.…”