EMOTIONAL AND BEHAVIOR DISORDERS IN CHILDREN WITH CHRONIC DISEASES

JURNALUL PEDIATRULUI – Year IX, Vol. IX, Nr. 33-34, january-june 2006

EMOTIONAL AND BEHAVIOR DISORDERS
IN CHILDREN WITH CHRONIC DISEASES


Luminita Ionica1, Maria Lucacela2, I Popa2, Ioana Popa2, I Velea2
1National Centre of Cystic Fibrosis Timisoara
2Clinic II pediatrics, University of Medicine and Pharmacy “Victor Babe?” Timisora


Summary
disease the children go over an important period of their life
The children with chronic diseases are subjected to
(childhood and/or adolescence), bearing on their shoulders a
a psychic stress that generates unexpected emotional and
much to heavy burden, which is the chronic disease with all
behavior reactions, which surprise both physicians and it’s implications that unfold in time(1).
parents. The study performed at the 2nd Pediatrics Clinic

Timisoara has as a goal the setting of a diagnosis of the
The goal of the study
emotional and behavior disorders of the children with
We set ourselves the goal to trace out the emotional
chronic diseases to ease up the interaction of the physicians
and behavior disorders in the investigated children with
with these patients and also to come to the aid of parents
three types of chronic diseases: mucoviscidosis, diabetes
with new information in the domain.
mellitus, bronchial asthma and also the find out, if possible,
Key words: emotional and behavior disorders, children,
some correlations between the disease and the emotional
chronic diseases.
and behavior disorders of these children.


Introduction
Working method
Since 1946, W.H.O. has defined health as being “a
The studied group consisted of 33 subjects
complete physical, mental and social well-being which hospitalized in the 2nd Pediatrics Clinic Timisoara in the
consists in the lack of disease and infirmities”(4).
period 2005 – 2006, having an average age of 10 years, of
This definition “underlines the dynamic interaction
which:
and interdependence between the three components of
• 18 cases of mucoviscidosis
health: the physic condition, the psychic equilibrium and the
• 10 with insulin dependent diabetes mellitus
social environment”(4).
• 5 with persistent bronchial asthma.
“A child with chronic diseases or infirmity is two
All the cases were evaluated at two consecutive
times sick: through the basic disease or infirmity and hospitalizations and a third examination was made at a
through it’s perturbation of his morph functional, physical,
distance of one year (Fig.1).
intellectual, behavioral and social-emotional
development”(2). Once with the detection of a chronic






5



Mucoviscidosis

Diabetes mellitus

18
Bronchial asthma

10








Fig.1.The cases were evaluated.



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JURNALUL PEDIATRULUI – Year IX, Vol. IX, Nr. 33-34, january-june 2006

-
The tree test – is also a projective test. The
The used methods and tests
study of the drawings gives information about
a. The direct observation of the subject’s behavior,
the social attitude of the subject, about his
was done in the Psychological consulting room of
intimate self (EGO), about his endeavors,
the Mucoviscidosis Center Timisoara regardless of
wishes and needs.
the type of chronic disease.
-
The family test. Projective test that highlights
b. The clinical interview – was aimed at obtaining
the relationship of the subject with his
information and the understanding of the
family, attracting attention on eventual

psychological functioning of the patient through
conflicts inside the family which could have
focusing on his life experience and with emphasis
negative responses in the psychic life of the
on the relationship established in the interview
child.
situation (3).
-
The Raven test. It is a perceptive, non-verbal
c. The anamnesis – has as a goal the collecting of data
test for the assessment of general
referring to the important events in the life of the
intelligence.
subject, and also to the eventual clinical records.
d. The specific tests used in the psychological Results (Fig.5).
examination of children:
57,14% of the children with mucoviscidosis have
- The “draw a person” test (Machover test) – is a
attachment disorders and 42,85% from them are affectively
projective test, the drawing of the person immature (Fig.2). In the group of children with bronchial
representing a real personal stamp. The analysis of
asthma 66,66%of them suffer from anxiety, emotional
the drawing gives information about the lability and the rest of 33,33% of them are affectively
characteristic traits of the child and about the immature (Fig.3).
existence of eventual psychic, intellectual or
emotional disorders.



5 7 , 1 4
6 0


5 0
4 2 , 8 5


4 0

3 0


2 0


1 0


0

A t t a c h m e n t d is o rd e rs
A ffe c t ive im m a t u rit y


Fig.2. Emotional and behavior disorders in children with mucoviscidosis.



66,66
70


60

50


40
33,33


30

20


10


0

Anxiety
Affective immaturity


Fig.3. Emotional and behavior disorders in children with bronchial asthma.


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JURNALUL PEDIATRULUI – Year IX, Vol. IX, Nr. 33-34, january-june 2006

From the analyzed children with insulin dependent
The comparative analysis of the three groups of
diabetes mellitus 50% were affectively immature and 25%
patients shows that from the point of view of the affective
of them showed irritability and even hostility to the persons
immaturity the first place is taken by the children with
around them.(Fig.4).
insulin dependent diabetes mellitus (Fig.6).



60

50

50


40


30
25

20


10


0

Affective immaturity
Irritability, hostility


Fig. 4. Emotional and behavior disorders in children with insulin dependent diabetes mellitus.



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Fig.5 Comparative chart of the general frequency with which emotional

and behavior disorders appear in children with chronic diseases.





Mucoviscidosis
42,85



Insulin dependent
50

diabetes mellitus


Bronchial asthma
33,3



0
10
20
30
40
50
60


Fig. 6 Comparative chart, of the affective immaturity percentage,

on groups of diseases, in the established batch.


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JURNALUL PEDIATRULUI – Year IX, Vol. IX, Nr. 33-34, january-june 2006

Discussions
of hostility towards the physicians or the


The parents-child-disease relationship in
medical profession.
mucoviscidosis. The family is a complex system (in this
In most of the cases parents offer their full support
environment every interaction between it’s components has
to the child. There are also dysfunctional families, in which
an echo at the level of the whole system). More than that,
the relationship disorders have a negative impact on the sick
the intervention of a powerful and unexpected vector can
child. The psychological implications of bronchial asthma
break the fragile equilibrium of the interaction field, which
on different age groups. The small child is more vulnerable
characterizes the family life.
emotionally to the asthma crises, because he does not
The family dysfunctions have negative effects on
understand them. When the family climate is very stern, the
the behavioral and health status of the child with cystic
parents not showing clearly their affection to the child and
fibrosis. Based on the experience of the Mucoviscidosis
often applying punishments, the small patient can perceive
Center it was established that:
wrongly the disease. The psychological implications that
• Most of the parents react with a psycho-emotional
appear in time in the child with diabetes mellitus. The child
block after hearing the diagnosis.
has to gain confidence in him, in the family and in the
• In the next phase appears confusion (they are not
medical team, which is why his education raises the problem
sure that they have understood well).
of finding a direct way to transmit information, having in
• Some of them deny the possibility that this disease
mind the limits of his understanding.
affects their child and even want to repeat the tests.

Parents react in accordance with their personality:
Conclusions
-
some become excessively anxious,
The work hypothesis was confirmed, namely, in
-
others become depressive,
children with chronic diseases the presence of emotional and
-
they try to maintain the equilibrium and not
behavior disorders was established as statistically
induce fear in the sick child,
significant.
-
the partner is blamed for the child’s disease
The obtained results are valid only for the
(sometimes). We have not encountered cases
investigated subjects, being impossible to extrapolate them
to all the children suffering from the chronic diseases
mentioned in the paper.


References:
2. Ciofu C., (1998)- Interac?iunea p?rin?i-copii, Bucure?ti,
1. Alm?jan I., B?canu R., Ionic? L., Popa Z., ( 2005)-
Ed. Amaltea.
Psychological aspects of life quality at children and
3. Dafinoiu I., (2002)- Personalitatea. Metode de abordare
teenagers with cystic fibrosis, Jurnalul Pediatrului nr.
clinic?, Ia?i, Ed. Polirom
29-30, ianuary-june 2005.
4. Perciun V., (2000)- Psihologie medical?, Timi?oara, Ed.
Eurostampa.


Correspondence to:
Luminita Ionica
Timisoara, Romania
National Centre of Cystic Fibrosis
Str. Paltinis, Nr. 2
Tel. +4-0256-491742


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