Mustafa YÜKSEL, Pınar KURU BEKTAŞOĞLU, Aliye Tuğba BAHADIR, Ceyda AFACAN, Aylin ÇAKIROĞLU ESER

Psychosocial functioning in pediatric patients with pectus excavatum and pectus carinatum

Background/aim: Pectus excavatum and pectus carinatum are the most commonly seen anterior chest wall deformities. Recent studies reveal that minimal invasive repair of pectus deformities improves the quality of life. Our aim is to assess the psychosocial functioning and sociodemographic characteristics of pediatric patients with pectus deformities and evaluate the differences between patients operated on with minimal invasive repair techniques and nonoperated patients. Materials and methods: Thirty-two patients with pectus deformities who were operated on 6 months or more before and 31 nonoperated patients participated in the study. The Children s Depression Inventory, Piers-Harris Children s Self-Concept Scale, Capa Social Phobia Scale for Children and Adolescents, Strengths and Difficulties Questionnaire - Self-Report Version (SDQ-SR), and State-Trait Anxiety Inventory for Children - Trait Version were completed by the patients. The SDQ-Parent Report Version (SDQ-PR) was completed by their parents. Results: There were no statistically significant differences between operated and nonoperated patient groups in terms of total scores on the psychiatric rating scales. Prosocial behavior subscale scores in SDQ-SR (P = 0.013) and SDQ-PR (P = 0.019) were lower in the operated group. Conclusion: Prosocial behavior levels were lower in the operated group. Further exploration of the psychosocial profile of pediatric patients with pectus deformities would better elucidate their needs in the course of their socioemotional development.

PDF

___

1. Fokin AA, Steuerwald NM, Ahrens WA, Allen KE. Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg 2009; 21: 44-57.
2. Lawson ML, Cash TF, Akers R, Vasser E, Burke B, Tabangin M, Welch C, Croitoru DP, Goretsky MJ, Nuss D et al. A pilot study of the impact of surgical repair on disease-specific quality of life among patients with pectus excavatum. J Pediatr Surg 2003; 38: 916-918.
3. Steinmann C, Krille S, Mueller A, Weber P, Reingruber B, Martin A. Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. Eur J Cardio-Thorac 2011; 40: 1138-1145.
4. Bostanci K, Ozalper MH, Eldem B, Ozyurtkan MO, Issaka A, Ermerak NO, Yuksel M. Quality of life of patients who have undergone the minimally invasive repair of pectus carinatum. Eur J Cardio-Thorac 2013; 43: 122-126.
5. Bahadir AT, Kuru P, Afacan C, Ermerak NO, Bostanci K, Yuksel M. Validity and reliability of the Turkish version of the Nuss questionnaire modified for adults. Korean Journal of Thoracic and Cardiovascular Surgery 2015; 48: 112-119.
6. Hanna WC, Ko MA, Blitz M, Shargall Y, Compeau CG. Thoracoscopic Nuss procedure for young adults with pectus excavatum: excellent midterm results and patient satisfaction. Ann Thorac Surg 2013; 96: 1033-1038.
7. Metzelder ML, Kuebler JF, Leonhardt J, Ure BM, Petersen C. Self and parental assessment after minimally invasive repair of pectus excavatum: lasting satisfaction after bar removal. Ann Thorac Surg 2007; 83: 1844-1849.
8. Ji Y, Liu W, Chen S, Xu B, Tang Y, Wang X, Yang G, Cao L. Assessment of psychosocial functioning and its risk factors in children with pectus excavatum. Health Qual Life Out 2011; 9: 28.
9. Nuss D, Kelly RE Jr, Croitoru DP, Katz ME. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg 1998; 33: 545-552.
10. Croitoru DP, Kelly RE Jr, Goretsky MJ, Lawson ML, Swoveland B, Nuss D. Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients. J Pediatr Surg 2002; 37: 437-445.
11. Jaroszewski D, Notrica D, McMahon L, Steidley DE, Deschamps C. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med 2010; 23: 230-239.
12. Grozavu C, Iliaş M, Marin D, Pantile D, Dabelea C, Augustin T. Minimally invasive repair for pectus excavatum - aesthetic and/or functional? Chirurgia-Bucharest 2013; 108: 70-78.
13. Abramson H. A minimally invasive technique to repair pectus carinatum. Preliminary report. Arch Bronconeumol 2005; 41: 349-351.
14. Krasopoulos G, Dusmet M, Ladas G, Goldstraw P. Nuss procedure improves the quality of life in young male adults with pectus excavatum deformity. Eur J Cardio-Thorac 2006; 29: 1-5.
15. Kuru P, Bostanci K, Ermerak NO, Bahadir AT, Afacan C, Yuksel M. Quality of life improves after minimally invasive repair of pectus excavatum. Asian Cardiovascular and Thoracic Annals 2015; 23: 302-307.
16. Kelly RE Jr, Cash TF, Shamberger RC, Mitchell KK, Mellins RB, Lawson ML, Oldham K, Azizkhan RG, Hebra AV, Nuss D et al. Surgical repair of pectus excavatum markedly improves body image and perceived ability for physical activity: multicenter study. Pediatrics 2008; 122: 1218-1222.
17. Rumsey N, Harcourt D. Body image and disfigurement: issues and intervention. Body Image 2004; 1: 83-97.
18. Elkind D. Egocentrism in adolescence. Child Dev 1967; 38: 1025-1034.
19. Choudhury S, Blakemore SJ, Charman T. Social cognitive development during adolescence. Soc Cogn Affect Neur 2006; 1: 165-174.
20. Knudsen MV, Grosen K, Pilegaard HK, Laustsen S. Surgical correction of pectus carinatum improves perceived body image, mental health and self-esteem. J Pediatr Surg 2015; 50: 1472-1476.
21. Dion J, Blackburn ME, Auclair J, Laberge L, Veillette S, Gaudreault M, Vachon P, Perron M, Touchette É. Development and aetiology of body dissatisfaction in adolescent boys and girls. International Journal of Adolescence and Youth 2015; 20: 151-166.
22. Kovacs M. The Childrens Depression Inventory (CDI). Psychopharmacol Bull 1985; 21: 995-998.
23. Öy B. Childrens Depression Inventory: a study of reliability and validity. Turk Psikiyatr Derg 1991; 2: 132-136 (in Turkish with an abstract in English).
24. Piers EV, Harris DB. Age and other correlates of self-concept in children. J Educ Psychol 1964; 55: 91-95.
25. Piers EV, Harris DB. Piers-Harris Childrens Self Concept Scale (The Way I Feel About Myself). Nashville, TN, USA: Counselor Recordings and Tests; 1969.
26. Çataklı M, Öner N. The Turkish form of the Piers-Harris Childrens Self-Concept Scale: a study of transliteral equivalence and reliability. Boğaziçi Üniversitesi Dergisi Eğitim Bilimleri 1986-1987; 12: 85-100 (in Turkish with an abstract in English).
27. Öner N. Piers-Harrisin Çocuklar İçin Öz Kavram Ölçeği El Kitabı. Ankara, Turkey: Türk Psikologlar Derneği Yayınları; 1994 (in Turkish).
28. Demir T. Çocuk ve ergenlerde sosyal fobi: epidemiyolojik bir çalışma. Expertise thesis, İstanbul University, İstanbul, Turkey, 1997 (in Turkish).
29. Demir T, Eralp-Demir D, Özmen E, Uysal Ö. Çapa Çocuk ve Ergenler için Sosyal Fobi Ölçeğinin geçerlilik ve güvenilirliği. Düşünen Adam 1999; 12: 23-30 (in Turkish).
30. Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psyc 1997; 38: 581-586.
31. Goodman R. The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psyc 1999; 40: 791-799.
32. Goodman R. Psychometric properties of the Strengths and Difficulties Questionnaire. J Am Acad Child Psy 2001; 40: 1337-1345.
34. Spielberger CD. Manual for the State-Trait Anxiety Inventory for children. Palo Alto, CA, USA: Consulting Psychologists Press; 1973.
35. Özusta HS. Çocuklar için Durumluk-Sürekli Kaygı Envanteri uyarlama, geçerlik ve güvenirlik çalışması. Turk Psikol Derg 1995; 10: 32-44 (in Turkish).
36. Siu AMH, Shek DTL, Lai FHY. Predictors of prosocial behavior among Chinese high school students in Hong Kong. Scientific World Journal 2012: 2012: 489156.
37. Krille S, Müller A, Steinmann C, Reingruber B, Weber P, Martin A. Self- and social perception of physical appearance in chest wall deformity. Body Image 2012; 9: 246-252.
38. Andersson G, Sandberg S, Rydell AM, Gerdin B. Social competence and behaviour problems in burned children. Burns 2003; 29: 25-30.
39. Lauth B, Arnkelsson GB, Magnússon P, Skarphéðinsson GÁ, Ferrari P, Pétursson H. Parent-youth agreement on symptoms and diagnosis: assessment with a diagnostic interview in an adolescent inpatient clinical population. J PhysiologyParis 2010; 104: 315-322.
40. Sterzer P, Stadler C, Poustka F, Kleinschmidt A. A structural neural deficit in adolescents with conduct disorder and its association with lack of empathy. Neuroimage 2007; 37: 335- 342.
41. Penner LA, Dovidio JF, Piliavin JA, Schroeder DA. Prosocial behavior: multilevel perspectives. Annu Rev Psychol 2005; 56: 365-392.