父母的焦虑、抑郁对白血病患儿情绪及自我意识的影响

目的探讨白血病患儿父母的焦虑和抑郁情绪发生情况，以及对患儿情绪及自我意识发展的影响。方法采用自评量表对30例初诊、20例长期无病生存白血病患儿及其父母进行心理测评。以年龄、性别、受教育程度、父母文化程度相匹配的学生50名为健康对照组。结果白血病儿童父母的焦虑和抑郁得分[（48．56±9．23）分和（51．86±9．53）分]均显著高于我国常模组[（37．23±12．59）分和（41．88±10．57）分1（均P=0．000），其中初诊白血病患儿父母的焦虑和抑郁症状检出率（60．0％和46．7％）显著高于长期无病生存组（25．0％和20．0％）（均P〈0．05）；患儿父母的焦虑和抑郁得分有明显相关I生（r=0．947，P=0．000）。长期无病生存组患儿在焦虑总分[（25．805-13．98）分1以及躯体化／惊恐[（6．11±4．36）分]、广泛性焦虑[（5．72±4．56）分]和社交恐怖[（7．67±4．19）分]量表评分均显著高于健康对照组[（15．90±10．52）分、（3．68±3．39）分、（2．54±2．99）分、（4．24±2．88）分]（均P〈0．05），而初诊组患儿社交恐怖分量表得分[（6．03±2．16）分]显著高于健康对照组[（4．24±2．88）分]（P=0．016）。白血病患儿的抑郁得分与其父母的焦虑得分（r=0．309，P=0．029）和抑郁得分（r：0．342，P=0．015）均有明显相关性。长期无病生存组患儿的自我意识总分[（60．80±6．25）分]以及幸福与满足分量表得分[（7．95±1．32）分]显著低于健康对照组[（64．484．-7．89）分、（8．64±1．19）分]（P：0．039、0．026），而初诊组患儿的自我意识总分[（59．83±5．87）分]以及行为[（12．47±1．25）分]、智力与学校情况[（10．80±2．12）分]、躯体外貌与属性[（8．40±2．66）分]、焦虑[（9．93±1．29）分]分量表得分均显著低于健康对照组[（64．48±7．89）分、（14．00±2．17）分、（12．60±2．96）分、（9．64±2．30）分、（11．38±2．18）分1（均P〈0．05）；其合群分量表得分与其父母的焦虑得分有明显相关性（r=0．337，P=0．017）。结论白血病患儿的父母较健康对照组父母有更多的焦虑和抑郁情绪，且对患儿情绪和自我意识的发展有一定影响。

Effects of parental anxiety and depression on the feelings and self-concept of children with leukemia

Objective To evaluate the anxiety and depression problems in children parents with leukemia, as well as the problems' influence to the psychosocial characteristics of leukemia children.Methods Twenty long-term survivors of childhood leukemia (group A), thirty children newly diagnosed as leukemia (group B) and fifty age-matched healthy controls (group C) completed the questionnaires allowing assessment of symptoms associated with anxiety, depression and self-concept. At the same time, the anxiety and depression in the parents of children with leukemia were also measured using SAS and SDS. Results The anxiety and depression scores of the parents in study group (48.56±9.23, 51.86±9.53) were much higher than that in normal population (37.23±12.59, 41.88±10.57) (P = 0.000, 0.000, respectively), the positive rate of anxiety and depression symptoms among group B was significantly higher than that among group A (60.0 % vs 25.0 %, 46.7 % vs 20.0 %; P <0.05, respectively). There was a significant positive relation between the depression and anxiety scores in the parents of children with leukemia(r =0.947, P =0.0000). Group A scored significantly higher on subscales of somatization/panic (6.11 ±4.36), generalized anxiety (5.72±4.56),social phobia (7.67±4.19) and the total scale (25.8±13.98) than group C (the score was 3.68±3.39, 2.54±2.99,4.24±2.88 and 15.9±10.52, respectively) (P<0.05, respectively), group B scored significantly higher on subscales of social phobia (6.03 ±2.16) than group C (4.24±2.88) (P =0.016). There was a significantly positive relation between the depression score in children with leukemia and the anxiety (r = 0.309, P = 0.029) & depression(r = 0.342, P = 0.015) scores in their parents. Group A scored significantly higher on the total score of self-concept(60.8±6.25) as well as the subscales of happiness(7.95±1.32) than group G (64.48±7.89 vs 8.64±1.19) (P =0.039, 0.026, respectively); and group B scored significantly higher on subscales of behavior (12.47±1.25), intelligence(10.80±2.12), physical appearance and attributes (8.40±2.66), anxiety (9.93±1.29) and the total scale (59.83±5.87) than group C (14.00±2.17, 12.60±2.96, 9.64±2.30, 11.38+2.18, 64.48±7.89) (P <0.05, respectively). There was a significantly positive relation between the score of gregarization subscale in leukemic children and the anxiety score in their parents (r = 0.337, P = 0.017). Conclusion The findings of our studies have suggested that the parents of children with leukemia are at risk for psychological difficulties, and which have a great influence on the psychological health of their children.