Affective and somatoform disorders in children in clinical settings of pulmonary department, their prevalence and impact on patient’s life quality

Abstract

Chronic respiratory diseases affect the personality and emotional state of the people who experience them. Purpose - to determine the incidence of hyperventilation syndrome (HVS) and depressive disorder in patients with organic and functional pathologies of the lungs at the pulmonary department and to assess their impact on the life quality of patients. Materials and methods. We have examined 131 patients aged 6-17, among them there were 54.9% (n=72) boys and 45.1% (n=59) girls. The patients were divided into three groups: the children with somatoform disorder (SD) from the respiratory system 33.6% (n=44), those with bronchial asthma (BA) - 34.3% (n=45) and those with pneumonia - 32.1% (n=42). For the diagnosis of depression we used a questionnaire for children’s depression by M. Kovacs (1992), for the diagnosis of HVS we used Nijmegen questionnaire. To determine the patient’s quality of life we used Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Results. The main structure of HVS 25 (19.1%) was composed of 17 (68%) children with SD, 5 (20%) children with BA and 3 (12%) children with pneumonia. Mild depression was determined in 56 (81.1%) sick children, an average one was found in 13 (19.9%) sick children. The severity of depression was significantly higher in the patients with SD in comparison to the patients with BA (95% CI: 6.5-15.5; p<0.0001) and in comparison to the patients with pneumonia (95% CI: 3.2-12.0; p<0.0009). The children with SD had the lowest rate of quality of life according to the PQ-LES-Q scale in comparison to the children with BA (95% CI: 5.4-14.6; p<0.0001) and the ones with pneumonia (95% CI: 6.2-12.6; p<0.0001). Conclusions. Hyperventilation syndrome occurs in 25 (19.1%) of the patients with pulmonary pathologies in childhood. In general, 69 (52.6%) of the children had depressive symptoms. Most likely, the basis of low satisfaction with the quality of life in patients with pulmonary pathology might be depressive disorders, as evidenced by the inverse and strong correlation between the data scales for depression and quality of life, whereby r=-0.773 (p<0.0001). The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee for all participants. Informed consent of the child’s parents was obtained for the research. No conflict of interests was declared by the authors. Key words: depression, bronchial asthma, pneumonia, somatoform disorder, quality of life, children.