Health-related quality of life, anxiety, and depressive symptoms in children with primary immunodeficiencies

Abstract

Nina B Kuburovic,1 Srdjan Pasic,2 Gordana Susic,3 Dejan Stevanovic,4 Vladimir Kuburovic,5 Slavisa Zdravkovic,6 Mirjana Janicijevic Petrovic,7 Tatjana Pekmezovic8 1Department of Public Health, Mother and Child Health Care Institute of Serbia, 2Department of Immunology, Pediatric Clinic, Faculty of Medicine, University of Belgrade, 3Institute for Rheumatology, Clinical Center of Serbia, 4Clinic for Neurology and Psychiatry for Children and Adolescents, 5Pediatric Clinic, Mother and Child Health Care Institute of Serbia, 6Pediatric Day Hospital, Mother and Child Health Care Institute of Serbia, Belgrade, 7Faculty of Medical Sciences, University of Kragujevac, Kragujevac, 8Serbia Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Introduction: The aims of this study were to evaluate levels of health-related quality of life (HRQOL) and the presence of anxiety and depressive symptoms in children with primary immunodeficiency disease (PID) in Serbia. Materials and methods: Self- and parent-rated data from 25 children with PID were available. As controls, data from 50 children with juvenile idiopathic arthritis (JIA) and 89 healthy children were included. The Pediatric Quality of Life Inventory was used for HRQOL assessments. Anxiety symptoms were identified using the Screen for Child Anxiety-Related Emotional Disorders questionnaire, while depressive symptoms were identified using the Mood and Feeling Questionnaire. Results: Children with PID had significantly lower Pediatric Quality of Life Inventory total scores compared to children with JIA and healthy children as child-rated (P=0.02) and parent-rated (P<0.001). Specifically, they had significantly lowered emotional functioning compared to children with JIA, and social functioning compared to both children with JIA and healthy children. School functioning was significantly lower among children with PID (parent-rated only). By parent-rated responses, six (24%) out of 25 children with PID had significant anxiety symptoms, while five (20%) children had significant depressive symptoms, which was statistically higher than among children with JIA and healthy controls (P=0.05). Conclusion: HRQOL could be significantly compromised in children with PID, particularly across such psychosocial domains as emotional, social, and school. These children were also found to be at an increased risk for suffering significant anxiety and depressive symptoms. Keywords: children, anxiety, depression, primary immunodeficiency disease, quality of life