Ebeveynleri COVID-19 Geçiren Çocuk ve Ergenlerde Psikolojik Sağlamlık, Depresyon, Anksiyete ve Travma Sonrası Stres Bozukluğu Belirtileri

Aralık 2019'da, Çin'de Yeni Koronavirüs (SARS-CoV-2) olarak bilinen bir koronavirüs tespit edilmiş ve dünya çapında bir salgın haline gelmiştir. COVID-19’dan korunmanın temel yolu, izolasyon ve sosyal uzaklaşma stratejileri olmuştur. Bu çalışmada, COVID-19 nedeni ile izole edilen ebeveynlerin çocuklarını depresyon, anksiyete ve travma sonrası stres bozukluğu (TSSB) belirtileri açısından değerlendirdik. Çalışmaya anne ve/veya babası son 3 ay içinde COVID-19 enfeksiyonu geçirmiş 52 çocuk dahil edilmiştir. Çocukların yaşları 7 yaş ile 17 yaş arasındadır ve 27’si kızdır. Tüm çocuklara, Çocuklar için Depresyon Ölçeği, Çocuklar için Travma Sonrası Stres Tepki Ölçeği, Çocukluk Anksiyete Tarama Ölçeği, Psikolojik Sağlamlık Ölçeği uygulanmıştır. Çocukların %19.2’sinde depresif semptomların olduğu, depresyon semptomların kronik hastalığı olanlarda %40, tanı almış psikiyatrik hastalığı olanlarda %50 olduğu tespit edilmiştir. Çocuklarda, değişen düzeylerde TSSB belirtileri saptanmıştır. Annesi izole edilenlerde, ağır TSSB belirtileri oranı %35.1; babası izole edilenlerde %6.7’dir. Her iki ebeveyni de COVID-19 enfeksiyonu geçiren çocuklarda anksiyete puanı en yüksek bulunurken, bunu sırasıyla sadece annesi geçiren çocuklar ve sadece babası geçirenler izlemiştir. Bilim adamlarının koronavirüsü iyi anladıkları, ülkemizde Sağlık Bakanlığı’nın süreci iyi yönettiği, koronavirüsün yayılmasını kısıtlamak için kendi alacağı ve ülkemizde alınacak koruyucu önlemlerin fark oluşturacağı fikrine katılmayan çocuklarda depresyon semptom sıklığı daha yüksek bulunmuştur. Ayrıca, bilim adamlarının koronavirüsü iyi anladıkları fikrine katılmayan ve ülkemizde uygulanan kuralların günlük yaşamlarına çok fazla müdahalede bulunduğunu düşünen çocuklarda, ağır TSSB belirti sıklığının daha yüksek olduğu gösterilmiştir. COVID-19 salgını ile günlük yaşamları kısıtlanmış olan çocukların; bilişsel, duygusal, fiziksel ve psikolojik gelişimlerinin henüz tamamlanmamış olduğu dikkate alındığında, bu süreçte yaşayabilecekleri sorunlara karşı uyumlarını arttırmak, psikolojik dayanıklılıklarını güçlendirmek için ruhsal destek sunulmalı ve etkin stratejiler izlenmelidir.

Anahtar Kelimeler:

COVID-19, çocuk, depresyon, anksiyete, travma sonrası stres, algılanan tehdit

Psychological Resilience, Symptoms of Depression, Anxiety, and Post-Traumatic Stress Disorder in Children and Adolescents whose Parents With COVID-19

In December 2019, a coronavirus known as Novel Coronavirus (SARS-CoV-2) was detected in China and turned into a pandemic. The main strategy to avoid COVID-19 infection has been isolation and social distancing strategies. Therefore, we evaluated the children of parents who were isolated due to COVID-19 in terms of depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Fifty-two children whose mother and / or father had been infected with COVID-19 in the last three months were included in the study. The children's ages vary between the ages of 7 and 17; 27 of them are girls. The Child Depression Scale, Post-Traumatic Stress Response Scale for Children, Childhood Anxiety Screening Scale, and Psychological Resilience Scale were administered to all children. It was determined that 19.2% of the children had depressive symptoms; the frequency of depression symptoms was 40% in those with chronic disease and 50% in those with a diagnosed psychiatric disorder. Various levels of PTSD symptoms were observed in all children included in the present study. While the rate of severe PTSD symptoms was 35.1% in those whose mothers were isolated; It was found to be 6.7% in those whose fathers were isolated. Children whose both parents were infected with COVID-19 had the highest anxiety scores, followed by children whose only mothers were infected and whose only fathers were infected, respectively. The depression symptoms were found to be more frequent in children who disagreed with the idea that scientists understand the coronavirus well, that the Ministry of Health in Turkey manages the process well, that the measures taken by themselves or the government will make a difference. In addition, it has been shown that severe PTSD symptoms are more frequent in children who disagree with the idea that scientists understand the coronavirus well and who think that the rules applied in Turkey interfere too much with their daily lives. Children whose daily life was restricted by the COVID-19 Pandemic; considering that their cognitive, emotional, physical, and psychological development has not yet been completed, psychological support should be provided, and effective strategies should be followed to increase their adaptation to the problems they may experience during this process, to strengthen their psychological resilience.

Keywords:

COVID-19, child, depression, anxiety, posttraumatic stress, percieved threat,

PDF

___

Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020; 8(5): 475-81.
Terhakopian A, Benedek DM. Hospital disaster preparedness: mental and behavioral health interventions for infectious disease outbreaks and bioterrorism incidents. American journal of disaster medicine. 2007; 2(1): 43-50.
Fasina OF, Jonah GE, Pam V, Milaneschi Y, Gostoli S, Rafanelli C. Psychosocial effects associated with highly pathogenic avian influenza (H5N1) in Nigeria. Veterinaria italiana. 2010; 46(4): 459-65.
Bonanno GA, Ho SM, Chan JC, Kwong RS, Cheung CK, Wong CP, et al. Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: a latent class approach. Health Psychology. 2008; 27(5): 659.
Chong M-Y, Wang W-C, Hsieh W-C, Lee C-Y, Chiu N-M, Yeh W-C, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. The British Journal of Psychiatry. 2004; 185(2): 127-33.
Sim M. Psychological trauma of Middle East Respiratory Syndrome victims and bereaved families. Epidemiology and health. 2016; 38.
Elizarrarás-Rivas J, Vargas-Mendoza JE, Mayoral-García M, Matadamas-Zarate C, Elizarrarás-Cruz A, Taylor M, et al. Psychological response of family members of patients hospitalised for influenza A/H1N1 in Oaxaca, Mexico. BMC psychiatry. 2010; 10(1): 1-9.
Keita MM, Taverne B, Savané SS, March L, Doukoure M, Sow MS, et al. Depressive symptoms among survivors of Ebola virus disease in Conakry (Guinea): preliminary results of the PostEboGui cohort. BMC psychiatry. 2017; 17(1): 1-9.
Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement. World journal of pediatrics. 2020; 16(3): 223-31.
Manuell ME, Cukor J. Mother Nature versus human nature: public compliance with evacuation and quarantine. Disasters. 2011; 35(2): 417-42.
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The lancet. 2020; 395(10227): 912-20.
Ge L, Yap CW, Ong R, Heng BH. Social isolation, loneliness and their relationships with depressive symptoms: a population-based study. PloS one. 2017; 12(8): e0182145.
Rossi R, Socci V, Talevi D, Mensi S, Niolu C, Pacitti F, et al. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Frontiers in psychiatry. 2020; 11: 790.
Seyahi E, Poyraz BC, Sut N, Akdogan S, Hamuryudan V. The psychological state and changes in the routine of the patients with rheumatic diseases during the coronavirus disease (COVID-19) outbreak in Turkey: a web-based cross-sectional survey. Rheumatology international. 2020; 40(8): 1229-38.
Shahrour G, Dardas LA. Acute stress disorder, coping self‐efficacy and subsequent psychological distress among nurses amid COVID‐19. Journal of nursing management. 2020; 28(7): 1686-95.
Shi L, Lu Z-A, Que J-Y, Huang X-L, Liu L, Ran M-S, et al. Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic. JAMA network open. 2020; 3(7): e2014053-e.
Cooper K. Don't let children be the hidden victims of COVID-19 pandemic. 2020.
Jiao WY, Wang LN, Liu J, Fang SF, Jiao FY, Pettoello-Mantovani M, et al. Behavioral and emotional disorders in children during the COVID-19 epidemic. The journal of Pediatrics. 2020; 221: 264.
Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. The Lancet Child & Adolescent Health. 2020; 4(5): 347-9.
Control CfD, Prevention. Data and statistics on children’s mental health. Retrieved April. 2019; 17: 2019.
Dalton L, Rapa E, Stein A. Protecting the psychological health of children through effective communication about COVID-19. The Lancet Child & Adolescent Health. 2020; 4(5): 346-7.
Singh S, Roy MD, Sinha CPTMK, Parveen CPTMS, Sharma CPTG, Joshi CPTG. Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry research. 2020: 113429.
Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. The Canadian Journal of Psychiatry. 2009; 54(5): 302-11.
Sim K, Chan YH, Chong PN, Chua HC, Soon SW. Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease. Journal of psychosomatic research. 2010; 68(2): 195-202.
Xie X, Xue Q, Zhou Y, Zhu K, Liu Q, Zhang J, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA pediatrics. 2020; 174(9): 898-900.
Liang L, Ren H, Cao R, Hu Y, Qin Z, Li C, et al. The effect of COVID-19 on youth mental health. Psychiatric quarterly. 2020; 91(3): 841-52.
Oosterhoff B, Palmer CA, Wilson J, Shook N. Adolescents' motivations to engage in social distancing during the COVID-19 pandemic: associations with mental and social health. Journal of Adolescent Health. 2020; 67(2): 179-85.
Chen F, Zheng D, Liu J, Gong Y, Guan Z, Lou D. Depression and anxiety among adolescents during COVID-19: A cross-sectional study. Brain, behavior, and immunity. 2020.
Kovacs M. Rating scales to assess depression in school-aged children. Acta Paedopsychiatrica: International Journal of Child & Adolescent Psychiatry. 1981.
Öy B. Çocukluk Depresyonu Derecelendirme Ölçeği: Sağlıklı ve Çocuk Ruh Sağlığı Kliniğine Başvuran Çocuklarda Uygulanması. Türk Psikiyatri Dergisi. 1991; 2(2): 137-40.
Pynoos RS, Frederick C, Nader K, Arroyo W, Steinberg A, Eth S, et al. Life threat and posttraumatic stress in school-age children. Archives of general psychiatry. 1987; 44(12): 1057-63.
Erden G, Kılıç E, Uslu R, Kerimoğlu E. Çocuklar için travma sonrası stres tepki ölçeği: Türkçe geçerlik, güvenirlik çalışması. Çocuk ve Gençlik Ruh Sağlığı Dergisi. 1999; 6(3): 143-49.
Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. Journal of the American academy of child & adolescent psychiatry. 1999; 38(10): 1230-6.
Karaceylan Çakmakçı F. Çocuklarda anksiyete bozukluklarını tarama ölçeği geçerlik ve güvenirlik çalışması. Yayınlanmamış tıpta uzmanlık tezi, Kocaeli Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları ABD, Kocaeli. 2004.
Liebenberg L, Ungar M, Vijver FVd. Validation of the child and youth resilience measure-28 (CYRM-28) among Canadian youth. Research on social work practice. 2012; 22(2): 219-26.
ARSLAN G. Çocuk ve Genç Psikolojik Sağlamlık Ölçeği’nin (ÇGPSÖ) psikometrik özellikleri: Geçerlilik ve güvenirlik çalışması. Ege Eğitim Dergisi. 2015; 16(1): 1-12.
Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020; 14(5): 779-88.
Humphreys KL. Future directions in the study and treatment of parent–child separation. Journal of Clinical Child & Adolescent Psychology. 2019; 48(1): 166-78.
Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan journal of medical sciences. 2020; 36(COVID19-S4): S67.
Orrù G, Rebecca C, Gemignani A, Conversano C. Psychological intervention measures during the COVID-19 pandemic. 2020.
Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. The Lancet. 2020; 395(10228): 945-7.
Ozamiz-Etxebarria N, Dosil-Santamaria M, Picaza-Gorrochategui M, Idoiaga-Mondragon N. Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cadernos de saude publica. 2020; 36: e00054020.
Campbell-Sills L, Cohan SL, Stein MB. Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behaviour research and therapy. 2006; 44(4): 585-99.
Steinhardt M, Dolbier C. Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. Journal of American college health. 2008; 56(4): 445-53.
Benard B. Resiliency: What we have learned. WestEd, 2004.
Sprang G, Silman M. Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster medicine and public health preparedness. 2013; 7(1): 105-10.
Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research and public health. 2020; 17(5): 1729.
Gillham JE, Shatté AJ, Reivich KJ, Seligman ME. Optimism, pessimism, and explanatory style. 2001.
Kwok KO, Li KK, Chan HH, Yi YY, Tang A, Wei WI, et al. Community responses during the early phase of the COVID-19 epidemic in Hong Kong: risk perception, information exposure and preventive measures. MedRxiv. 2020.
Dalton L, Rapa E, Ziebland S, Rochat T, Kelly B, Hanington L, et al. Communication with children and adolescents about the diagnosis of a life-threatening condition in their parent. The Lancet. 2019; 393(10176): 1164-76.
Çaykuş ET, Çaykuş TM. COVID-19 Pandemi Ssürecinde Çocukların Psikolojik Dayanikliliğini Güçlendirme Yollari: Ailelere, Öğretmenlere Ve Ruh Sağliği Uzmanlarina Öneriler. ASEAD. 2020;7(5):95-113.