Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

Depressie, angst en een verminderd gevoel van eigenwaarde bij kinderen met insuline-afhankelijke diabetes mellitus en coeliakie vergeleken met gezonde controles

(2012) Draaisma, E. (Eelco)

In the past decades, a fair body of literature has been published on the prevalence of psychologic comorbidity among chronically ill children, compared to healthy controls. Several authors have concluded that psychological complaints occur more frequently among children with a chronic medical condition. Other investigations found no differences between chronically ill and healthy children in terms of psychopathology. Various researchers have used different definitions of psychological complaints. Varying instruments have been used to quantify these complaints, including interviews that allowed psychiatric (DSM-) diagnoses to be made, questionnaires filled out by parents or teachers and questionnaires completed by children themselves. To my knowledge, research of this kind has never been conducted in the Netherlands.
This study tested the hypothesis that psychological morbidity, defined as complaints of a depressive mood, anxiety or a low level of self-esteem, occurs more frequently among a group of Dutch children with insulin-dependent diabetes mellitus (IDDM) and celiac disease, compared to a group of healthy children.
20 patients with IDDM, 26 with celiac disease and 39 matched, healthy control subjects, aged eight to fifteen years, completed self-report questionnaires (Dutch versions) quantifying the presence of symptoms of depression (Children’s Depression Inventory), anxiety (State-Trait Anxiety Inventory for Children, Fear Survey Schedule for Children-Revised) and low self-esteem (Self-Perception Profile, different versions for Children and Adolescents).
Median scores on relevant (sub)scales of these instruments were compared between the following groups: 1) IDDM versus controls, 2) celiac disease versus controls, 3) IDDM + celiac disease versus controls. None of these comparisons conveyed significant differences (p-values varying from 0.194 to 0.995). 95% confidence intervals were calculated for the difference in median scores between groups. All intervals contained zero, which was a further indication that no significant differences between groups exist at population level. Post-hoc analysis revealed no differences between the proportions of IDDM-patients and other subjects who reported fear of injections (p = 0.485).
The results argue against the initial hypothesis and are suggestive of the existence of comparable levels of psychologic (co)morbidity among Dutch children suffering from IDDM and celiac disease and their healthy counterparts. The main strength of this study was its adequate methodological design. The major limitation was an insufficient number of participants.

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