The study of cognitive functioning and psychosocial aspects of children and adolescents with multiple sclerosis

[S. B. Ostojić]

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Medicina - Pedijatrija, dečija neurologija / Medicine - Pediatrics, children's neurology

Multipla skleroza (MS) je hronična autoimunska inflamatorna bolest centralnog nervnog sistema, sa diseminovanim demijelinacionim lezijama CNS. Ova bolest je jedno od najčešćih uzroka onesposobljenosti kod mladih odraslih osoba. Oko 2 -5% obolelih prve simptome bolesti ima pre 18. godine, a kod oko 1% obolelih ova bolest počinje pre 10. godine života. Procena težine bolesti samo na osnovu objektivnog kliničkog nalaza nije dovoljna, jer ne daje uvid u subjektivni doživljaj simptoma bolesti i teškoće sa kojima se ovi bolesnici sreću u svakodnevnom životu. Merenje kvaliteta života je sveobuhvatnije u proceni zdravlja u odnosu na testove koji procenjuju samo neurološki deficit bolesnika sa multiplom sklerozom. Cilj: Cilj ove studije je bila procena kognitivnih funkcija i kvaliteta života kod dece i adolescenata obolelih od multiple skleroze, kao i njihova korelacija sa kliničko-demografskim obeležjima bolesti. Metodologija: Ova studija je dizajnirana kao studija preseka kod dece i aodolescenata sa dijagnozom MS. Demografske i kliničke podatke prikupili smo za 26 bolesnika, a podatke o kvalitetu života, anksioznosti, depresiji i osećaju hroničnog zamora dobili smo od 21 ispitanika uzrasta od 14 do 18 godina. U proceni kvaliteta života korišćeni su KIDSCREEN-52 upitnici za decu i roditelje. Revidirana skala za anksioznost i depresiju dece (Revised Children’s Anxiety and Depression Scale - RCADS) je korišćena da bi se procenili anksiozni i depresivni simptomi, a zamor je procenjivan primenom PedsFACIT-F upitnika za funkcionalnu procenu terapije hronične bolesti u pedijatriji (Pediatric - Functional Assessment of Chronic Illness Therapy-Fatigue - PedsFACIT-F). Rezultati: Svi ispitanici su imali blagi stepen neurološkog deficita, sa EDSS (Proširena skala funkcionalne onesposobljenosti) skorom u opsegu od 0 do 3,5. U poređenju sa nacionalnim podacima za zdrave adolescente, skorovi procene fizičkog funkcionisanja su bili značajno niži kod adolescenata sa MS, prema podacima dobijenim kako od samih ispitanika, tako i od njihovih roditelja. Pet (23,8%) adolescenata je imalo RCADS skor unutar kliničkog značaja...

Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system (CNS), with disseminated demyelinating lesions of the CNS. Multiple sclerosis is one of the most common causes of severe disability in young adult people. Approximately 2 -5% of patients have the first symptoms of the disease before the age of 18 and in about 1% of patients the disease begins before the age of 10. Evaluation of disease severity based only on objective clinical findings is not sufficient, because it does not provide insight into the subjective experience of the symptoms of the disease and the difficulties that these patients have in everyday life. Measures of health-related quality of life (HRQOL) are considered to be more comprehensive in health outcome assessments than the scales assessing only the degree of neurological deficit of patients with multiple sclerosis (MS). Objective: The aim of the study was to evaluate cognitive functions and HRQOL and its correlates with clinical and demographic characteristics of the disease among children and adolescents with MS. Methods: A cross-sectional study was performed in children and adolescents with diagnosis of MS. Demographic and clinical data were collected for 26 patients, and we received the data on quality of life, anxiety, depression and chronic fatigue from 21 subjects with MS, aged 14 to 18 years. The KIDSCREEN-52 measures for children and parents were used in HRQOL assessments. Anxiety and depressive symptoms were identified by the Revised Child Anxiety and Depression Scale (RCADS), while fatigue was assessed by the Pediatric - Functional Assessment of Chronic Illness Therapy-Fatigue (PedsFACIT-F)...

kognitivne funkcije, anksioznost, depresija, zamor, multipla skleroza, pedijatrija, deca i adolescenti, kvalitet života

cognititive function; anxiety; depression; fatigue; multiple sclerosis; pediatric; children and adolescents; quality of life

616.8-053.2(043.3)

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