Evaluation of Mental Health and Related Factors among Patients with Beta-Thalassemia Major in South East of Iran

Article excerpt

Objective: Beta-thalassemia major (β-TM) is a chronic, genetic and hematological disorder. Children and teenagers with chronic physical illnesses exemplified by thalassemia are vulnerable to emotional and behavioral problems. The aim of this study was to evaluate mental health and its related factors among young patients with beta-thalassemia major.

Methods: In this cross-sectional observational descriptive-analytic study, we studied 164 patients suffering from Beta-thalassemia major with age range of 15-24 years who referred for treatment to Ali Ebn-e Abitaleb (AS) University Hospital in Zahedan, a city in South East of Iran, during 2009- 2010. The demographic data and pattern of mental health were collected by standard general health questionnaire (GHQ-28).Data was analyzed using statistical software SPSS (version 17.0); Student t test and Chisquare (χ2) were used.

Results: In this study, 96 (58.5%) patients were male; the mean age of all patients was 18.78 ±2.28. Based on data analysis, 83 patients (50.8%) suspected to have psychiatric disorders (58.8% of girls, 44.8% of boys). In addition, frequency of somatic symptoms, depression disorder, anxiety disorder and social dysfunction in all patients were 7.3%, 11.6%, 8.5% and 4.3% respectively. In illiterate patients, 70.4% suspected to have psychiatric disorder. Except for somatic disorder, other mental disorders were more frequent in girls. No significant association was found between mental state and gender, marital and literacy status and occupation.

Conclusion : In this study, due to high prevalence of psychological disorders in young patients with Beta-thalassemia major, especially in girls, we suggest implementing further educational psychological programs to decrease the frequency of disorders. Moreover, conducting more quantitative and comprehensive researches is suggested to evaluate specific effective factors in psycho-social health.

Keywords: Beta-thalassemia, Iran, Mental health

Iran J Psychiatry 2012; 7:47-51

Beta-thalassemia major disease (β-TM) is a chronic and genetic disease characterized by hematologic abnormalities (1,2). Patients suffering from this disease are characterized by clinical manifestation of a severe chronic anemia, failure of growth, hepato-splenomegaly, bones disorders (specially head and face bones abnormality) (3). World Health Organization (WHO) introduced thalassemia as the most common chronic and genetic disorder in 60 countries, affecting lives of about 10,000 persons annually (4).Also, in Iran the most common genetic disease is thalassemia; as prevalence of β-thalassemia major disease was estimated to be about 22000 patients (4). The number of people with this disease in Sistan-

Balouchistanprovince in South East of Iran was estimated to be 1167 patients in 2001 (4).

According to other studies, 14 to 24 percent of patients with thalassemia major suffered from psychiatric disorders (3). Even in some studies, up to 80 percent of young patients with beta thalassemia major had serious psychiatric disorders (1, 2); to name a few it can be referred to somatization disorders (SOM), depression especially major depression disorder (MDD), obsessive-compulsive disorder (OCT), tic disorders, oppositional defiant disorders (ODD), psychosis, nocturnal enuresis nocturnal (2,3,5).In addition, somatic complaints, and interpersonal sensitivity are common psychological disorders in these patients (3).

Epidemiological surveys of mental disorders reported varying rates of 11.9% to 32.9% in Iran (6,7).

The difference in personal demographic-characteristics including gender, literacy status, duration of disease and its chronicity, past history of hospitalization due to severe complication of disease, expectance for precocious death due to disease complications, morbidity proceeded from disease, duration of treatment and intense remedies, early treatment, and increasing cost of treatment are among important factors associated with level of general (psycho-social) health, self-care behaviors and life expectancy in young patients with beta-thalassemia (4,8,9). …