Psychological outcome and quality of life in children born with congenital diaphragmatic hernia

• Published in: Archives of disease in childhood 2009-11, Vol.94 (11), p.834-840
• Main Authors: Peetsold, M G, Huisman, J, Hofman, V E, Heij, H A, Raat, H, Gemke, R J
• Format: Article
• Language: English
• Subjects: Academic Failure; Adaptation, Psychological; Adolescent; Age; Anatomy; Attention; Behavior Rating Scales; Biological and medical sciences; Check Lists; Child; Child Behavior; Child Behavior Disorders - epidemiology; Child Health; Children & youth; Cognition Disorders - epidemiology; Congenital diseases; Cross-Sectional Studies; Demographic aspects; Developmental Delays; Diaphragm; Diaphragmatic hernia; Ethics; Family medical history; Female; Follow-Up Studies; Gastroesophageal reflux; General aspects; Genetic disorders; Health aspects; Health Status; Hernia; Hernia, Diaphragmatic - epidemiology; Hernia, Diaphragmatic - psychology; Hernias; Hernias, Diaphragmatic, Congenital; Hospitals; Humans; Hypoxia; Informed Consent; Intelligence Quotient; Learning Disorders - epidemiology; Male; Medical sciences; Miscellaneous; Mortality; Multivariate analysis; Netherlands - epidemiology; Neuropsychological Tests; Nonverbal Tests; Parents & parenting; Patient outcomes; Patients; Pediatrics; Perceptions; Population; Prevention and actions; Psychological aspects; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Life; Self Concept; Social Behavior; Studies; Ventilation
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2008.156158

Objective: To assess psychological and social functioning and health related quality of life and its early determinants in children born with congenital diaphragmatic hernia (CDH). Design: Cross-sectional follow-up study. Setting: Outpatient clinic of a tertiary care hospital. Participants: 33 CDH survivors aged 6–16 years. Main exposure: Patients who developed CDH associated respiratory distress within 24 h after birth. Main outcome measure: Psychological and social functioning assessed with the Wechsler Intelligence Scale for Children (WISC-R), Bourdon-Vos test, Beery Developmental Test of Visual Motor Integration, Child Behavior Checklist (CBCL) and Teacher Report Form (TRF), and health related quality of life assessed with the Child Health Questionnaire (CHQ) and Health Utilities Index (HUI). Results: Normal mean (SD) total IQ (100.0 (13.2)) and normal visual-motor integration, but significantly lower results for sustained attention (Bourdon-Vos test, 38.8 (11.2) points) were found. Learning difficulties were reported by 30% of parents. Eight children had scores in the clinical range on the CBCL and/or TRF, indicating clinically significant behavioural problems. Except for the CHQ scale General Health, health status was not different from the reference population. No significant correlations between test results and severity of CDH were found, except for an association of general health and physical functioning with length of hospital stay. Conclusion: CDH patients are at risk for subtle cognitive and behavioural problems, probably not related to CDH severity. Perception of general health is reduced compared to the reference population, indicating that CDH survivors and their parents believe their health is poor and likely to get worse.