目的 分析长期口服糖皮质激素对慢性病患儿情绪心理状态的影响。方法 采用便利抽样方法,选取口服糖皮质激素类药物3个月及以上的10~18岁患儿140例,采用Piers-Harris儿童自我意识量表及儿童抑郁障碍自评量表等进行调查,运用分层回归分析方法探讨长期口服糖皮质激素对患儿情绪心理状态的影响。结果 本研究中138名慢性病患儿自我意识得分为55.50±11.49,29.0%的患儿自我意识水平较低;抑郁障碍自评量表得分为9.11±4.81,15.9%的患儿存在抑郁障碍。分层回归分析结果显示,激素用药状况可分别解释自我意识、抑郁障碍5.6%、3.1%的变异量。结论 长期口服糖皮质激素会影响慢性病患儿的情绪心理状态,易出现自我评价较低、抑郁障碍等负性情绪反应,应予以关注。
Abstract
Objective To analyse the influence of long-term oral use of glucocorticoid on mood and mental state of children with chronic disease.Method Totally 140 children with chronic illness aged from 10 to 18 were selected by convenience sampling to finish the self-designed questionnaire,Piers-Harris Children's Self-concept Scale(PHCSS) and Depression Self-Rating Scale for Children (DSRSC).Multiple hierarchical regression analysis was used to explore the effect of extended oral glucocorticoid on mood and mental state of participants.Results The average score of self-concept scale and depression scale were 55.50±11.49 and 9.11±4.81 respectively.29.0%children reported low level of self-concept(<50 scores)and 15.9% children were with high level of depression.The results of hierarchical regression analysis showed that the long-term oral use of glucocorticoid could explain 5.6% of the variance in self-concept and 3.1% in depression.Conclusion Long-term oral use of glucocorticoid could influence the mood and mental state of children with chronic disease,who are prone to appear low level of self-evaluation and depression disorder.
关键词
长期 /
糖皮质激素 /
自我意识 /
抑郁 /
患儿
Key words
long-term /
glucocorticoid /
self-concept /
depression /
pediatric patients
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参考文献
[1] Shiff NJ,Brant R,Guzman J,et al.Glucocorticoid-related changes in body mass index among children and adolescents with rheumatic diseases[J].Arthritis Care Res,2013,65(1):113-121.
[2] Kavanaugh A,Wells AF.Benefits and risks of low-dose glucocorticoid treatment in the patient with rheumatoid arthritis[J].Rheumatology,2014,53(10):1742-1751.
[3] Drozdowicz LB,Bostwick JM.Psychiatric adverse effects of pediatric corticosteroid use[J].Mayo Clin Proc,2014,89(6):817-834.
[4] Morin C,Fardet L.Systemic glucocorticoid therapy:risk factors for reported adverse events and beliefs about the drug.A cross-sectional online survey of 820 patients[J].Clin Rheumatol,2015,34(12):2119-2126.
[5] Mrakotsky C,Forbes PW,Bernstein JH,et al.Acute cognitive and behavioral effects of systemic corticosteroids in children treated for inflammatory bowel disease[J].J Int Neuropsychol Soc,2013,19(1):96-109.
[6] Kodish T,Herres J,Shearer A,et al.Bullying,depression,and suicide risk in a pediatric primary care sample[J].Crisis,2016,37(3):1-6.
[7] Knight A,Weiss P,Morales K,et al.Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients:a cross-sectional study[J].Pediatr Rheumatol,2014,12:42.
[8] 苏林雁,王凯,朱焱,等.儿童抑郁障碍自评量表的中国城市常模[J].中国心理卫生杂志,2003,17(8):547-549.
[9] 毛美玲,王秀玲,谢金英.哮喘患儿情绪自我意识及其父母情绪特征研究[J].中国儿童保健杂志,2010,18(10):798-801.
[10] 孙鑫,杨艳杰,郑玉珍,等.艾滋病儿童自我意识及相关因素研究[J].中国临床心理学杂志,2016,24(5):849-851.
[11] Top u S,Orhon F,Tayfun M,et al.Anxiety,depression and self-esteem levels in obese children:a case-control study[J].J Pediatr Endocrinol Metab,2016,29(3):357-361.
[12] Szigethy EM,Youk AO,Benhayon D,et al.Depression subtypes in pediatric inflammatory bowel disease[J].J Pediatr Gastroenterol Nutr,2014,58(5):574-581.
[13] Pietsch K,Allgaier A,Frühe B,et al.Screening for depression in adolescent paediatric patients:Validity of the new Depression Screener for Teenagers (DesTeen)[J].J Affect Disord,2011,133(1-2):69-75.
[14] Starkman MN.Neuropsychiatric findings in cushing syndrome and exogenous glucocorticoid administration[J].Endocrinol Metab Clin North Am,2013,42(3):477-488.
[15] Brown ES,Vera E,Frol AB,et al.Effects of chronic prednisone therapy on mood and memory[J].J Affect Disord,2007,99(1-3):279-283.
基金
2015-2016年度北京协和医学院护理学院临床护理学系科研基金项目(11-01-201503)
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