Psychological impact of chronic liver diseases in children

ABSTRACT

Care of children with chronic liver diseases is an important part of general practice. While the emphasis of management has traditionally been on the biomedical aspects of ill health categorized by specific medical diagnoses, other dimensions such as psychological manifestations may be important. To describe anxiety and depression in children suffering from chronic liver diseases. This case control study was conducted from January 2008 to December 2008 at outpatient clinic at Alwahda hospital, Derna-Libya. It included 350 children with ages ranging from 6 to 16 years with chronic liver diseases in addition to 700 children matched in age and sex with a rate 2 to 1 from school children of the same areas used as a control group. All children were subjected to full medical history, clinical examination and psychometric measures [I.Q by Goodenough -Harris, Anxiety Scale [CAS] and Depression Inventory [CDI]. The mean score values of IQ in children with chronic liver diseases was significantly lower than controls [82.6 +/- 10and 97.4 +/- 8, respectively, P<0.001] and the mean score values of CDI and CAS in children with chronic liver diseases [82.6 +/- 10, 13.3 +/- 6.4] were significantly higher than controls [11.2 +/- 3, and 7.6 +/- 2.6, P<0.001]. Chronic illness management offers a challenge to general practitioners to take on an expanded generalist role. Important psychological manifestations may be neglected and proposed case management reforms are a stimulus to reappraise the role of general practitioners in chronic liver illness and disease care