Psychosocial aspects and psychiatric disorders in children with thalassemia major.

beta-thalassemia major (TM), a chronic, genetically determined hematological disorder, has received little investigation on the psychological aspects of the disease and the psychosocial adjustment of patients with this anemia. In the present study, the aim was to assess the mental capacity, self-image, hopelessness and anxiety displayed by children who suffered from TM, and to investigate the existence of psychiatric disorders in these children. Twenty-five children (16 boys and 9 girls) with TM, 12.0-19.6 years old, from the Hematology Unit of the Department of Pediatrics at the SSK Tepecik Teaching Hospital, were included in the study. Fifteen healthy cases matched for age, sex and socio-economic status were used as controls. The Wechsler Intelligence Scale for Children (or Wechsler Adult Intelligence Scale), Offer Self-Image Questionnaire, Beck Hopelessness Scale, Trait Anxiety Inventory, Symptom Check List (revised) and the Family Assessment Device were performed on all patients. Then, the patients were evaluated for a psychiatric disorder by a psychiatrist (according to the diagnostic criteria of the Diagnostic and Statistical Manual IV of the American Psychiatric Association). The results for the patients and control cases were compared statistically using Mann-Whitney and Kruskal-Wallis tests. Self-image was found to be significantly lower in patients with TM than in control cases (P < 0.01). Hopelessness and Trait-Anxiety scores were determined to be significantly higher in patients with TM than in control cases (P < 0.01 and P < 0.05, respectively). Eighty percent of the patients with TM have had at least one psychiatric disorder. As a result, the study showed that most of the patients with TM had severe psychosocial problems. Relying on these data, it was concluded that medical therapy of these patients should be supported with psychological aid and psychiatric treatment.