Neuropediatrics 2013; 44(05): 257-264
DOI: 10.1055/s-0033-1347935
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Self-Reported Quality of Life and Depressive Symptoms in Children, Adolescents, and Adults with Duchenne Muscular Dystrophy: A Cross-Sectional Survey Study

Sigrid Elsenbruch
1   Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Julia Schmid
1   Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Soeren Lutz
2   Department of Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
,
Brigitte Geers
2   Department of Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
3   Department of Paediatric Neurology, Munich Children's Center, Munich, Germany
,
Ulrike Schara
2   Department of Paediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
› Author Affiliations
Further Information

Publication History

18 January 2013

15 April 2013

Publication Date:
21 June 2013 (online)

Abstract

Aim We aimed to address the impact of Duchenne muscular dystrophy (DMD) on self-reported health-related quality of life (HRQOL) and depressive symptoms in different age groups of patients to discern a possible need for improved psychosocial support or counseling.

Methods In a German clinic for pediatric neurology, we performed a cross-sectional questionnaire survey in a total of 50 patients with DMD (i.e., n = 15 children aged 8 to 12 years; n = 11 adolescents aged 13 to 16 years; n = 24 young adults aged 17 to 23 years). We assessed self-reported HRQOL and symptoms of depression using validated, age-appropriate instruments.

Results In children with DMD, virtually all aspects of HRQOL were significantly impaired when compared with published normative data for boys with other chronic illnesses. On the contrary, adolescents and adults with DMD did not differ from published normative data in psychosocial areas of HRQOL, despite significant reductions in physical aspects of HRQOL. Clinically relevant depressive symptoms were not observed in either age group.

Interpretation DMD may not always be associated with impaired psychosocial HRQOL and clinical depression, although progressive physical impairment leads to reduced physical aspects of HRQOL. Only children with DMD demonstrated marked impairments in psychosocial aspects of HRQOL calling for psychosocial interventions tailored to this age group.

 
  • References

  • 1 Bushby K, Finkel R, Birnkrant DJ , et al; DMD Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol 2010; 9 (1) 77-93
  • 2 Toussaint M, Steens M, Wasteels G, Soudon P. Diurnal ventilation via mouthpiece: survival in end-stage Duchenne patients. Eur Respir J 2006; 28 (3) 549-555
  • 3 Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord 2002; 12 (10) 926-929
  • 4 Kohler M, Clarenbach CF, Bahler C, Brack T, Russi EW, Bloch KE. Disability and survival in Duchenne muscular dystrophy. J Neurol Neurosurg Psychiatry 2009; 80 (3) 320-325
  • 5 Cirak S, Arechavala-Gomeza V, Guglieri M , et al. Exon skipping and dystrophin restoration in patients with Duchenne muscular dystrophy after systemic phosphorodiamidate morpholino oligomer treatment: an open-label, phase 2, dose-escalation study. Lancet 2011; 378 (9791) 595-605
  • 6 Baiardini I, Minetti C, Bonifacino S , et al. Quality of life in Duchenne muscular dystrophy: the subjective impact on children and parents. J Child Neurol 2011; 26 (6) 707-713
  • 7 McDonald CM, McDonald DA, Bagley A , et al. Relationship between clinical outcome measures and parent proxy reports of health-related quality of life in ambulatory children with Duchenne muscular dystrophy. J Child Neurol 2010; 25 (9) 1130-1144
  • 8 Bray P, Bundy AC, Ryan MM, North KN, Everett A. Health-related quality of life in boys with Duchenne muscular dystrophy: agreement between parents and their sons. J Child Neurol 2010; 25 (10) 1188-1194
  • 9 Rahbek J, Werge B, Madsen A, Marquardt J, Steffensen BF, Jeppesen J. Adult life with Duchenne muscular dystrophy: observations among an emerging and unforeseen patient population. Pediatr Rehabil 2005; 8 (1) 17-28
  • 10 Boström K, Ahlström G. Living with a chronic deteriorating disease: the trajectory with muscular dystrophy over ten years. Disabil Rehabil 2004; 26 (23) 1388-1398
  • 11 Kohler M, Clarenbach CF, Böni L, Brack T, Russi EW, Bloch KE. Quality of life, physical disability, and respiratory impairment in Duchenne muscular dystrophy. Am J Respir Crit Care Med 2005; 172 (8) 1032-1036
  • 12 Reid DT, Renwick RM. Relating familial stress to the psychosocial adjustment of adolescents with Duchenne muscular dystrophy. Int J Rehabil Res 2001; 24 (2) 83-93
  • 13 Grootenhuis MA, de Boone J, van der Kooi AJ. Living with muscular dystrophy: health related quality of life consequences for children and adults. Health Qual Life Outcomes 2007; 5: 31
  • 14 Uzark K, King E, Cripe L , et al. Health-related quality of life in children and adolescents with Duchenne muscular dystrophy. Pediatrics 2012; 130 (6) e1559-e1566
  • 15 Brooke MH, Fenichel GM, Griggs RC , et al. Clinical investigation in Duchenne dystrophy: 2. Determination of the “power” of therapeutic trials based on the natural history. Muscle Nerve 1983; 6 (2) 91-103
  • 16 Schmidt S, Petersen C, Mühlan H , et al; The DISABKIDS Group Europe. The DISABKIDS Questionnaires: Quality of Life Questionnaires for Children with Chronic Conditions. Lengerich, Germany: Pabst Science Publishers; 2006
  • 17 Bullinger M, Kirchberger I. Fragebogen zum Gesundheitszustand. Handanweisung. Göttingen, Germany: Hogrefe Verlag; 1989
  • 18 Stiensmeier-Pelster P, Schürmann M, Duda K. Depressions-Inventar für Kinder und Jugendliche. Handanweisung. 2nd ed. Göttingen, Germany: Hogrefe Verlag; 2000
  • 19 Hautzinger M, Bailer M, Worall H, Keller F. Beck-Depressions-Inventar (BDI). Testhandbuch. Bern, Switzerland: Verlag Hans Huber; 1994
  • 20 Bray P, Bundy AC, Ryan MM, North KN, Burns J. Health status of boys with Duchenne muscular dystrophy: a parent's perspective. J Paediatr Child Health 2011; 47 (8) 557-562
  • 21 Abresch RT, Seyden NK, Wineinger MA. Quality of life. Issues for persons with neuromuscular diseases. Phys Med Rehabil Clin N Am 1998; 9 (1) 233-248
  • 22 Spies S, Schipper K, Nollet F, Abma TA. Duchenne muscular dystrophy. BMJ 2010; 341: c4364
  • 23 Nätterlund B, Gunnarsson LG, Ahlström G. Disability, coping and quality of life in individuals with muscular dystrophy: a prospective study over five years. Disabil Rehabil 2000; 22 (17) 776-785
  • 24 Abi Daoud MS, Dooley JM, Gordon KE. Depression in parents of children with Duchenne muscular dystrophy. Pediatr Neurol 2004; 31 (1) 16-19
  • 25 Hendriksen JG, Poysky JT, Schrans DG, Schouten EG, Aldenkamp AP, Vles JS. Psychosocial adjustment in males with Duchenne muscular dystrophy: psychometric properties and clinical utility of a parent-report questionnaire. J Pediatr Psychol 2009; 34 (1) 69-78
  • 26 Bray P, Bundy AC, Ryan MM, North KN. Feasibility of a computerized method to measure quality of “everyday” life in children with neuromuscular disorders. Phys Occup Ther Pediatr 2010; 30 (1) 43-53