Parenting Stress Profile and Children Behaviour in Patients with Congenital Hypothyroidism

Abstract

Background: Hypothyroidism has been associated with cognitive and motor impairments, the degree to which mild hypothyroidism, or subclinical hypothyroidism impacts mood and cognitive functions and whether these symptoms respond to treatment, remains controversial. Furthermore, hypothyroidism is associated with an increased susceptibility to depression and reductions in health-related quality of life. Objective and hypotheses: Recent longitudinal studies stressed that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioural profiles in children with CHT and the parenting stress profiles. Method: Data for children and families characteristics were collected from 33 families with a CHT child (13 males, 20 females; age: 6 months–6 years) diagnosed and treated since the newborn period. We analyzed the children by the Denver intelligence test and the child behaviour checklist (CBCL). Furthermore we proposed the parenting stress index (PSI) to their parents. Results: Denver intelligence test results demonstrated that nine/33 patients were normal, 20/33 were dubious, four/33 were not estimable. However the specific neuropsychiatric evaluation and QI confirmed a reduced performance only in three. The CBCL was normal in 18/33 patients (ten females; eight males), borderline in 8/33 (five females; three males), pathological in 7/33 (five females; two males). The children younger than 2 years showed a pathological or borderline score, with the exception of two. Between these, the more frequently pathological items were somatic complaints (five pathological; four borderline), anxious/depressed (two pathological; four borderline), attention problems (one pathological; four borderline). The PSI revealed a pathological test in six/33 patients. All the items were pathological in two; however in all the six pathological patients the PSI identified a ‘difficult child’. No correlations were found between starting day of treatment and developmental outcome. Initial T4 concentration and initial T4 dose were weak predictors for developmental outcome. Conclusion: The diagnosis of a chronic disease of the son could interfere with the emotional relationship in the family.