The Influence of Depression and School Life on the Quality of Life of Korean Child and Adolescent Patients with Attention-Deficit/Hyperactivity Disorder: A Comparison of the Perspectives of the Patients and Their Caregivers원문보기
Park, Byeong-Eon
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Lee, Jeong-Seop
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Kim, Hee-Yun
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Bae, Jae-Nam
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Kim, Won-Hyoung
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Kim, Hye-Young
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Rim, Mi-Roo
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Kang, Sang-Gu
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
,
Choi, Seo-Hyun
(Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center)
Objectives: This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the s...
Objectives: This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life reported by the patients and their caregivers. Methods: The patients' quality of life and their degree of depression and anxiety were measured using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-Report, the Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale, respectively. The caregivers' perception of the patients' quality of life and severity of the ADHD symptoms were measured using the PedsQL 4.0 Parent Proxy Report and the Conners' Parent Rating Scale (CPRS), respectively. A total of 66 participants completed the survey. The independent-samples t-test, Pearson's correlation analysis, and multiple regression analysis were conducted. Results: The mean score of the PedsQL 4.0 Child Self-Report was significantly higher than the mean score of the PedsQL 4.0 Parent Proxy Report. However, for school function, the PedsQL 4.0 Child Self-Report score was significantly lower than that of Parent Proxy Report. The correlation between the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores was significant only for emotional function and social function. The multiple regression analysis showed that the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores were significantly predicted by the CDI and CPRS scores, respectively. Conclusion: Our results demonstrate that there are clear differences between the quality of life reported by the patient themselves and that reported by their caregivers. In addition, the findings suggest that it is critical to treat the patients' accompanying depressive symptoms.
Objectives: This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life reported by the patients and their caregivers. Methods: The patients' quality of life and their degree of depression and anxiety were measured using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-Report, the Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale, respectively. The caregivers' perception of the patients' quality of life and severity of the ADHD symptoms were measured using the PedsQL 4.0 Parent Proxy Report and the Conners' Parent Rating Scale (CPRS), respectively. A total of 66 participants completed the survey. The independent-samples t-test, Pearson's correlation analysis, and multiple regression analysis were conducted. Results: The mean score of the PedsQL 4.0 Child Self-Report was significantly higher than the mean score of the PedsQL 4.0 Parent Proxy Report. However, for school function, the PedsQL 4.0 Child Self-Report score was significantly lower than that of Parent Proxy Report. The correlation between the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores was significant only for emotional function and social function. The multiple regression analysis showed that the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores were significantly predicted by the CDI and CPRS scores, respectively. Conclusion: Our results demonstrate that there are clear differences between the quality of life reported by the patient themselves and that reported by their caregivers. In addition, the findings suggest that it is critical to treat the patients' accompanying depressive symptoms.
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문제 정의
In addition, ADHD can have a negative influence on various aspects of their life, including self-respect, social functions, and caregiver-andchild relationships [4]. Due to these, it is necessary to review the quality of life of patients with ADHD.
Therefore, this study aimed to directly ask the patients about their quality of life and to compare it with their quality of life as perceived by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life as reported by the patients and caregivers, respectively.
This study demonstrates that there are clear differences between the quality of life reported by the patients themselves and their quality of life reported by their caregivers. For these domestic patients, the quality of life in school was far lower, which suggests that it is necessary to investigate how to promote academic performance and improve ability.
가설 설정
Third, the research subjects were recruited from one hospital, which limits the generalization of the findings. Fourth, the sample size was not sufficient. Fifth, the study did not consider differences depending on the types of drugs used for treatment or comorbidities.
제안 방법
Therefore, this study aimed to directly ask the patients about their quality of life and to compare it with their quality of life as perceived by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life as reported by the patients and caregivers, respectively.
In this study, after obtaining both the ADHD patients’ and their caregivers’ evaluation of the patients’ quality of life and comparing them, the correlations between these factors were examined.
It was also translated from the general type of quality of life test for children that was created by Varni, Seid, and Kurtin and validated by Kook and Varni [13]. It contains a total of 23 questions that cover eight physical areas, five emotional areas, five social areas, and five school areas. In the study by Kook and Varni [13], the Cronbach’s α ranged between 0.
It was translated from the general version of the quality of life test for children that was created by Varni, Seid, and Kurtin and validated by Kook and Varni [13]. It has a total of 23 questions that cover eight physical areas, five emotional areas, five social areas, and five school areas. Each question is responded to on a scale ranging from 0 to 4 (0=no problem, 1=barely a problem, 2=sometimes a problem, 3=frequently a problem, and 4=almost always a problem).
In this study, after obtaining both the ADHD patients’ and their caregivers’ evaluation of the patients’ quality of life and comparing them, the correlations between these factors were examined. The correlations between the quality of life reported by the respective parties and the severity of the ADHD symptoms and the emotional problems, including depression and anxiety, which may affect quality of life, were then investigated. Through this, it was confirmed that the quality of life reported by the patients and that reported by the caregivers was different, and that the evaluation of the quality of life was affected by different and respective factors.
The simple version, which was developed after careful consideration of various psychometric evidence accumulated from the basic version, obtains more concise information about the children’s problematic behaviors.
To assess the severity of the patients’ ADHD symptoms, the Korean version of the Conners’ Parent Rating Scale (CPRS) was used. This scale is used in clinical settings and research studies to evaluate ADHD symptoms and the related problematic behaviors of children with ADHD between the ages of 3 and 17 years. There are two versions: the basic version (containing 93 questions) and the simple version (containing 48 questions).
대상 데이터
Among the patients in the outpatient setting of a university hospital’s Department of Psychiatry, those diagnosed with ADHD (based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders’ criteria) were recruited.
Among the patients in the outpatient setting of a university hospital’s Department of Psychiatry, those diagnosed with ADHD (based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders’ criteria) were recruited. The study focused on the patients in the outpatient setting of the Department of Psychiatry and their main caregivers between January 1, 2017 and February 28, 2018.
The subjects in the study were recruited between January and February 2017. Sixty-six questionnaires that had appropriate replies for all of the questions were used in the final analysis.
데이터처리
In order to comprehend the practical influence of the severity of the ADHD symptoms and emotional problems, including depression and anxiety, a multiple regression analysis was conducted (Table 6). The CDI, RCMAS, and CPRS scores were used as variables in the analysis.
Pearson’s correlation analysis was also conducted to examine the correlations between the functional aspects of quality of life and the other factors (i.e., the severity of the symptoms and problems, such as depression and anxiety).
To compare the quality of life reported by the patients and by the caregivers, the independent-samples t-test was used, and Pearson’s correlation analysis was applied to analyze the correlation between them.
이론/모형
To assess the severity of the patients’ ADHD symptoms, the Korean version of the Conners’ Parent Rating Scale (CPRS) was used.
To evaluate the patients’ anxiety, the Revised Children’s Manifest Anxiety Scale (RCMAS) was used, which was developed by Reynolds and Richmond and translated and adopted by Choi and Cho [16].
성능/효과
The CDI, RCMAS, and CPRS scores were used as variables in the analysis. As a result, the total score of the PedsQL 4.0 Child Self-Report was significantly predicted by the CDI score (beta coefficient=-1.147, standardized beta coefficient=-0.603) and the total score of the PedsQL 4.0 Parent Proxy Report was significantly predicted by the CPRS score (beta coefficient=-0.398, standardized beta coefficient=-0.417).
In addition, the RCMAS score was significantly correlated with the total score of the PedsQL 4.0 Child SelfReport, emotional function (Pearson’s coefficient=-0.599), and social function (Pearson’s coefficient=-0.522).
In general, the quality of life of the patients reported by the caregivers was more strongly related to the severity of the symptoms rather than to the emotional problems, including depression and anxiety, which is a similar finding to various previous studies [6-8]. In the results of the multiple regression analysis, the most expected factor of quality of life reported by the patients was depression while the most expected factor of quality of life reported by the caregivers was the severity of the symptoms. This result indicates that treating the accompanying symptoms of depression will be more helpful for improving the quality of life felt by the patients themselves when treating ADHD patients, and it is necessary to explore and treat the patients’ depressive symptoms in a pos itive way.
The total score of the PedsQL 4.0 Child Self-Report was correlated with the scores of the CDI and RCMAS (Pearson’s coefficient=-0.601 and -0.556 respectively) and there was a correlation with the psychosomatic factor sub-scale of the CPRS (Pearson’s coefficient=-0.331) (Table 4).
There were no significant correlations between the CPRS and the total score of the PedsQL 4.0 Child Self-Report or the sub-scales in general, although there was a significant correlation between the school function of the PedsQL 4.0 Child Self-Report and the total score of the CPRS (Pearson’s coefficient=0.316), particularly for the aspect of impulsivity-hyperactivity (Pearson’s coefficient=0.321).
When analyzing the correlation between the total score and the scores of the sub-factor scales of the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report, it was found that the emotional function (Pearson’s coefficient=0.408) and social function (Pearson’s coefficient=0.255) were significantly correlated although the association was weak to moderate (Table 3).
참고문헌 (18)
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