ABSTRACT
Sickle cell disease [SCD] in children with a history of repeated hospitalization is distressing for children as well as their parents leading to anxiety and has negative effects on the psychological state of children and their families. The aim of the study was to determine the overall effect of SCD on the behavior of young children age 1½ to 5 years old who had repeated history of hospitalization, compared to a control group of healthy children attended a vaccination clinic. Thirty-five children of age 1½ to 5 years who have SCD and repeated history of hospitalization were recruited from pediatric clinic as the study group and matched with same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist [CBCL] 1½ to 5 years and diagnostic and statistical [DSM]-oriented scale. Behavior data were collected through a semi-structured questionnaire. Children who have SCD had statistically significant behavioral changes on CBCL compared to the control group: Anxiety/depression [65.2 vs. 55.1; P < 0.001], somatic complaint [66.7 vs. 54.4; P < 0.001] withdrawn [63.4 vs. 53.2; P < 0.001], aggressive behavior [60.4 vs. 56; P=0.04], and internalizing symptoms [64.7 vs. 51.5; P< 0.001], respectively. The DSM scale showed that children with SCD scored significantly higher in pervasive developmental disorder compared to the control group [60.9 vs. 53.9; P < 0.001] respectively. Children with SCD who had history of repeated hospitalization are at an increased risk of developing behavioral problems. Psychological counseling, social support, and proper pain management could minimize these behavioral consequences
ABSTRACT
To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy [GO]. A prospective, controlled, University Hospital based study. The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup. Psychiatric changes were assessed with the Middlesex Hospital Questionnaire [MHQ]. Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone [TSH] concentrations, TSH receptor antibody [TRAb] activity and antrthyroglobulin particle agglutination [TGPA] and antithyroid microsomal particle agglutination [MCPA]. The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group [P<0.0001]. The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group [P<0.05]. The scale scores of depression and phobia showed a positive correlation with scores of anxiety [P<0.0001]. The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria [P<0.0001]. The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO