Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective

INTRODUCTION@#The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children.@*METHODS@#This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test.@*RESULTS@#A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems.@*CONCLUSION@#Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.

An approach to problem behaviours in children

Behavioural problems in children are a relatively common occurrence but are a concern for parents. Such problems are often a reflection of the child's social stressors, environment and developmental state. Although a majority of behavioural problems are temporary, some may persist or are symptomatic of neurodevelopmental disorders or an underlying medical condition. Initial management of behaviour problems often involves helping parents to learn effective behaviour strategies to promote desirable behaviours in their children. This article highlights a general approach to evaluating and treating behavioural problems in children in the primary care setting. Sleep problems, eating disorders, and other emotional and developmental disorders, such as autism spectrum disorder and attention deficit hyperactivity disorder, are not within the scope of this article.