Psychosocial Symptoms and Sleep in Adolescents with Paediatric Inflammatory Bowel Disease
Year: 2012
Type: dissertation
Study design: Observational Study
Abstract: According to the literature, risk for emotional symptoms, anxiety and social dysfunction is increased among youth with inflammatory bowel disease (IBD). Previous studies in this area are, however, sparse and in those that do exist, methodological problems occur. Frequency of sleep disturbances, daytime tiredness, and psychosocial symptoms related to sleeping difficulties in paediatric IBD are so far unstudied. The current study aimed to evaluate the frequency of psychosocial symptoms and sleep problems among Finnish adolescents with paediatric IBD compared to population-based controls. Both parents and adolescents themselves were used as a source of information. The data was collected in spring 2007 as a postal questionnaire-based survey. Parents and adolescents received standardised questionnaires that measured adolescents psychosocial symptoms, competence, sleep, and daytime tiredness (Child Behavior Checklist, CBCL, for parent; Youth Self-Report, YSR, and Sleep Self-Report, SSR, for adolescent). The final study includes 160 (56%) adolescents with IBD and 236 (27%) controls with their parents. The groups of patients and controls were similar according to demographic and descriptive characteristics (gender, age, place of residence and socio-economic status), and represented the whole country well. In the first study, parent and self-reported psychosocial symptoms and competence were evaluated among adolescents with IBD in comparison to the controls, and in the patients, according to severity of IBD symptoms. The main findings here were that the patients reported equally as much psychosocial problems in self-reports as the controls did, even though their parents reported significantly more emotional symptoms, somatic complaints, social problems, thought problems, and lower competence in their children compared to the parents of controls. The frequency of psychosocial problems correlated positively with the severity of IBD symptoms according to both respondents. This study suggests that self-rated questionnaires may not be efficient enough to measure psychosocial well-being of adolescents with IBD and, thus, complementary assessments should be applied. Furthermore, psychosocial evaluation especially among patients with severe IBD symptoms should be routinely applied in clinical visits. Parental evaluation is of great value and should be included in the psychosocial assessment of adolescents with IBD. The second study assessed parent-adolescent agreement regarding emotional, behavioural and somatic symptoms in adolescents with IBD. In 5% of the cases, parents and adolescents agreed on the presence of a psychosocial problem, but in 21% of the cases they disagreed. According to both respondents, no problems existed in 74% of the cases. Altogether, the parent-adolescent agreement rate was poor to low, being lowest on anxious/depressed mood and thought problems, and highest on social problems. The parents reported significantly more often somatic symptoms close to clinical range (subclinical) in their adolescents than the adolescents themselves did. These results indicate that in patients with paediatric IBD, parents and adolescents often disagree on patient s psychosocial problems and somatic complaints. Clinically significant psychosocial and somatic problems would stay unrecognised in this patient group without asking about these symptoms from both the parents and the adolescents themselves. The third study evaluated frequency of parent and self-reported sleep problems and daytime tiredness among adolescents with IBD in relation to the controls and, in the patient group, in relation to the severity of the disease. The results revealed that, according to the parental perception, adolescents with IBD are burdened with more frequent sleep disturbances and overtiredness than the controls. However, self-reported sleep problems and daytime tiredness were equally common in both groups. Parent and self-reported sleep problems and overtiredness associated positively with the self-reported severity of IBD symptoms. Thus, especially those adolescents with IBD who suffer from severe symptoms of the disease should be further assessed for sleep disturbances and daytime tiredness. Finally, the fourth study examined parent and self-reported psychosocial symptoms and somatic complaints in sleep-troubled (n=32) versus non-sleep troubled adolescents with IBD (n=125). According to both respondents, the sleep-troubled patients had more frequent psychosocial problems (especially anxiety/depressed mood and aggressive behaviour) and somatic complaints (various aches and nausea) than their counterparts without sleep trouble. Additionally, SSR-measured sleep quality correlated significantly with parent and self-reported attention problems. These results indicate that in those adolescents with IBD who self-perceive sleeping difficulties, further assessment of psychosocial symptoms and proper evaluation of somatic symptoms is needed, as are the interventions to improve sleep quality among them.
Source: Työväentutkimus Vuosikirja
Author: Teija Pirinen
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1547124592