Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
The Psychological Burden of the COVID-19 Pandemic on Children with Chronic Lung Disease: Anxiety and Depression in Bronchiolitis Obliterans: Prospective Cross-Sectional Research
Kronik Akciğer Hastalığı Olan Çocuklarda COVID-19 Pandemisinin Psikolojik Yükü: Bronchiolitis Obliterans'ta Anksiyete ve Depresyon: Prospektif Kesitsel Çalışma
Aslı İmran YILMAZa , Sevgi PEKCANa , Semih ERDENb , Gökçen ÜNALa , Fatih ERCANa , Suat SAVAŞa , Mehmet KÖSEc
aNecmettin Erbakan University Faculty of Medicine, Department of Pediatric Pulmonology, Konya, Türkiye
bNecmettin Erbakan University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Türkiye
cErciyes University Faculty of Medicine, Department of Pediatric Pulmonology, Kayseri, Türkiye
Turkiye Klinikleri J Pediatr. 2025;34(1):1-9
doi: 10.5336/pediatr.2024-106713
Article Language: EN
Full Text
ABSTRACT
 Objective: Bronchiolitis obliterans (BO) is a rare, irreversible chronic lung disease. The COVID-19 pandemic, especially through isolation and social restrictions, significantly impacted mental health, particularly in individuals with chronic conditions. This study aimed to evaluate anxiety and depression levels in children diagnosed with BO and their parents, comparing them with healthy controls. Material and Methods: Children diagnosed with BO between 2008 and 2020 and their parents were assessed through telehealth interviews. Sociodemographic data were collected. Psychological symptoms in parents were evaluated using the Brief Symptom Inventory (BSI), while children's quality of life was assessed via the Pediatric Quality of Life Inventory (PedsQL). Depression and anxiety in children were measured using the Childhood Depression Inventory (CDI) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), both validated for the Turkish population. Control groups included children of healthcare workers and non-healthcare workers. Results: The study included 34 children with BO, 34 children of healthcare workers, and 34 of nonhealthcare workers. Anxiety levels were significantly higher in BO patients and children of healthcare workers, while depressive symptoms were particularly elevated in the latter. Children with BO reported significantly lower physical quality of life. A positive correlation was found between child anxiety, decreased quality of life, and parental psychological distress. Conclusion: Children with BO and those of healthcare workers are at higher risk for anxiety and depression during pandemics, likely due to illness-related stress and parental occupational strain. Psychological support should be prioritized for these vulnerable groups in future outbreaks.

Keywords: Anxiety; bronchiolitis obliterans; child; depression; pandemic
ÖZET
 Amaç: Bronşiolitis obliterans (BO), nadir görülen, geri dönüşümsüz kronik bir akciğer hastalığıdır. COVID-19 pandemisi, özellikle izolasyon ve sosyal kısıtlamalar yoluyla, kronik hastalığı olan bireylerde ruh sağlığını önemli ölçüde etkilemiştir. Bu çalışmada, BO tanısı almış çocuklar ve ebeveynlerinde anksiyete ve depresyon düzeylerinin değerlendirilmesi ve sağlıklı kontrol gruplarıyla karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: 2008-2020 yılları arasında BO tanısı alan çocuklar ve ebeveynleri, tele-sağlık görüşmeleri ile değerlendirildi. Sosyodemografik veriler hasta dosyalarından toplandı. Ebeveynlerin psikolojik belirtileri Brief Symptom Inventory (BSI) ile, çocukların yaşam kalitesi ise Pediatric Quality of Life Inventory (PedsQL) ile değerlendirildi. Çocuklarda depresyon ve anksiyete düzeyleri, Türk toplumuna uyarlanmış Childhood Depression Inventory (CDI) ve Screen for Child Anxiety Related Emotional Disorders (SCARED) ölçekleri ile ölçüldü. Kontrol grupları, sağlık çalışanı ebeveynlerin çocukları ve sağlık çalışanı olmayan ebeveynlerin çocuklarından oluşmaktaydı. Bulgular: Çalışmaya 34 BO tanılı çocuk, 34 sağlık çalışanı çocuğu ve 34 sağlık çalışanı olmayan çocuğu dahil edildi. Anksiyete düzeyleri BO hastalarında ve sağlık çalışanlarının çocuklarında anlamlı şekilde yüksek bulundu; depresyon ise özellikle sağlık çalışanlarının çocuklarında yüksekti. BO'lu çocuklar fiziksel yaşam kalitesinde belirgin düşüş bildirdi. Çocuk anksiyetesi ile azalan yaşam kalitesi ve ebeveyn psikolojik sıkıntısı arasında pozitif korelasyon gözlendi. Sonuç: Pandemi dönemlerinde BO'lu çocuklar ve sağlık çalışanlarının çocukları anksiyete ve depresyon açısından artmış risk altındadır. Bu durum, hastalığa bağlı stres ve ebeveynlerin mesleki yüklerine bağlanabilir. Gelecek salgınlarda bu savunmasız gruplara yönelik psikolojik destek öncelikli olmalıdır.

Anahtar Kelimeler: Anksiyete; bronşiyolit obliterans; çocuk; depresyon; pandemi
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