DEPRESI DAN FAKTOR-FAKTOR YANG MEMPENGARUHI PADA PENDERITA THALASSEMIA BETA MAYOR

Komang Ayu R Purnamaningsih, Dr. Indria Laksmi Gamayanti, MSi., PSi.

2014 | Tesis | S2 Ked.Klinik/MS-PPDS

Latar Belakang: Thalassemia adalah salah satu anemia hemolitik herediter. Indonesia terletak di kawasan sabuk thalassemia dengan prevalensi tinggi thalassemia beta mayor. Anak-anak dengan penyakit kronis termasuk thalassemia memiliki risiko mengalami masalah psikologis seperti depresi. Tujuan: Menilai frekuensi depresi dan mengidentifikasi faktor-faktor yang berhubungan dengan depresi pada penderita thalassemia beta mayor. Metode: Penelitian cross-sectional dilakukan pada bulan Juli-Agustus 2012. Penelitian ini melibatkan: penderita thalassemia beta mayor usia 7-12 tahun; mendapat transfusi rutin tiap bulan; tinggal bersama kedua orang tua; tidak ada riwayat keluarga dengan penyakit psikologis. Subjek diambil secara konsekutif, dibandingkan dengan 56 anak sehat (matching usia, jenis kelamin, dan tempat tinggal). Depresi dinilai dengan kuesioner Modified Children’s Depression Inventory (MCDI). Faktor yang berhubungan dengan depresi yang dianalisis: usia, jenis kelamin, status sosial ekonomi, jumlah absensi sekolah, stres anak akibat persepsi terhadap sakit yang diderita, durasi sakit, durasi transfusi, durasi terapi kelasi besi, dan kepatuhan terhadap terapi kelasi besi. Hasil: Rerata skor MCDI pada penderita thalassemia lebih tinggi dibandingkan anak sehat [13,18 ± 5,24 vs 10,14 ± 3,92; mean difference 3,04 (IK 95% 1,29- 4,77; p = 0,001)]. Frekuensi depresi pada penderita thalassemia beta mayor sebesar 37,5% sedangkan anak sehat sebesar 16% (RP 3,13; IK 95% 1,28-7,67; p = 0,01). Diantara penderita thalassemia, hanya faktor stres anak akibat persepsi terhadap sakit yang diderita berkorelasi dengan depresi (r = 0,594, p = 0,000). Simpulan: Depresi lebih sering terjadi pada penderita thalassemia beta mayor dibandingkan anak sehat. Stres anak akibat persepsi terhadap sakit yang diderita berkorelasi dengan depresi pada penderita thalassemia beta mayor.

Background: Thalassemia is one of hereditary hemolytic anemia. Indonesia is located on the thalassemia belt region with high prevalence of thalassemia. Children with chronic illness including thalassemia have been proven to be a substantial risk for psychosocial problems such as depression. Objective: To assess frequency of depression and identify factors associated with depression in beta thalassemia major patients. Methods: A cross-sectional study was conducted on July-August 2012. We enrolled: 7-12 years old beta thalassemia major patients; get monthly transfussion; living with both parents; no family history of psychological illness. Subjects were taken consecutively and compared with 56 healthy children (matched age, sex, and residence ). Depression were assessed with Modified Children’s Depression Inventory (MCDI) questionnairess. Factors associated with depression were analyzed: sex, sosioeconomic status, days absent from school, child’s perception of illness stress, duration of illness, duration of transfussion, duration of chelation therapy, and compliance for chelation therapy. Results: The mean scores of MCDI in thalassemia children is higher than healthy children [13.18 ± 5.24 vs 10.14 ± 3.92; mean difference 3.04 (95% CI 1.29-4.77; p = 0.001)]. Frequency of depression in beta thalassemia major patients 37.5%, while in healthy children 16% (PR 3.13; 95% CI 1.28-7.67; p = 0.01). Among beta thalassemia major patients, only child’s perception of illness stress is correlated with depression (r = 0.594, p = 0.000). Conclusion: Depression is more common in beta thalassemia major patients compared to the healthy children. Child’s perception of illness stress is correlated with depression in beta thalassemia major patients.

Kata Kunci : frekuensi, depresi, thalassemia beta mayor