G539(P) Screening for depression among parents of patients with thalassemia using patient health questionnaire (phq-9)

Abstract

Aim Parents of thalassemia patients have to devote a significant proportion of their time to meet the ongoing medical needs of their children. This can adversely affect the time dedicated to their other children, and as carriers of the disease, they may be burdened significant guilt. We evaluated symptoms of depression among parents of these patients by PHQ-9, a well validated screening tool for assessing depression. Methods Parents and caregivers of patients with thalassemia in a Haemoglobinopathy Clinic were screened over a 2 month period using the Patient Health Questionnaire (PHQ-9). Responses were tabulated and analysed and the responses from male and female caregivers were analysed and compared separately. Results Parents of of 46 thalassemia patients were screened during the study. Responses were obtained from 37 fathers and 46 mothers of patients. Overall among all parents, 29% screened positive for minor or major symptoms of depression. Among the fathers, 29% (11) had minor symptoms on screening, but none had any symptoms of major depression. Whereas, among the mothers, only 8% (4) had minor symptoms with 21% (9) had major symptoms. In fact, in this cohort 6% (2) mothers had severely major depression. No thoughts of self harm were voiced by any caregivers, but 81% of fathers voiced feelings of inadequacy and 32% mentioned anger issues. In contrast, feelings of inadequacy or anger issues were voiced by only 15% of mothers. Conclusion Our study showed that almost a third of parents of children with thalassemia were suffering from depression and we recommend all parents should have access to proper counselling, with active screening and access to appropriate services. It was concerning to note that mothers were more liable to major depression requiring therapy. Though fathers were noted to have less severe symptoms of depression, more than 80% harboured feelings of guilt and inadequacy. As paediatricians, we need to be actively aware of the mental health issues of thalassemia parents and be vigilant to help them access appropriate services as required.