Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 7  |  Issue : 6  |  Page : 717-720  

Prevalence of anxiety and depression in mothers of children with profound bilateral sensorineural hearing loss: A brief report


1 Behavioral Science Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
2 New Hearing Technologies Research Center, Baqiyatallah University of Medical Center, Tehran, Iran
3 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
4 Student Research Committee, Baqiyatallah University of Medical Center, Tehran, Iran
5 Chemical Injuries Research Center, Baqiyatallah University of Medical Center, Tehran, Iran

Date of Web Publication18-Nov-2014

Correspondence Address:
Amin Saburi
Chemical Injuries research Center, Baqiyatallah University of Medical Sciences, Mollasadra St, Vanak Sq, Tehran
Iran
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Source of Support: This project was supported by New Hearing Technologies research center of Baqiyatallah university of medical sciences, Tehran, Iran., Conflict of Interest: None


DOI: 10.4103/0975-2870.144855

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  Abstract 

Background: Stress caused by physical disorders of offspring, such as deafness, is the potential reason of depression and anxiety in their parents. This study assessed the prevalence of depression and anxiety in mothers of children with sensorineural hearing disorders. Materials and Methods: An analytical cross-sectional study was conducted on 59 mothers of children diagnosed with profound sensorineural deafness who were referred to Baqiyatallah university hospitals in 2009. Depression and anxiety were assessed by depression and anxiety questionnaire (Beck Second edition). Results: The mean ages of children and mothers were 18.31 ± 4.72 months and 29.42 ± 4.39 years, respectively. The prevalence of depression and anxiety were 39 out of 59 (66.10%) and 47 out of 59 (79.66%), respectively. Conclusion: Depression and anxiety in mothers of children with profound sensorineural hearing loss have a high incidence and psychological complications must be considered substantially in mothers of children with hearing disorders.

Keywords: Anxiety, depression, mother, sensorineural hearing loss


How to cite this article:
Noohi S, Amirsalari S, Sabouri E, Moradi S, Saburi A. Prevalence of anxiety and depression in mothers of children with profound bilateral sensorineural hearing loss: A brief report. Med J DY Patil Univ 2014;7:717-20

How to cite this URL:
Noohi S, Amirsalari S, Sabouri E, Moradi S, Saburi A. Prevalence of anxiety and depression in mothers of children with profound bilateral sensorineural hearing loss: A brief report. Med J DY Patil Univ [serial online] 2014 [cited 2024 Mar 29];7:717-20. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2014/7/6/717/144855


  Introduction Top


Mood and anxiety disorders are two of the most common symptoms in psychiatry. Some of the responsible agents are stressful events or constitutional reasons. [1] Environmental predisposing factors, such as family problems specially severe types (e.g., children's severe and chronic diseases) are clear causes of mental disorders (specially in mothers). [1],[2] In a normal stimulatory stress response, usually with a threatening issue and a separatation, anxiety and depression occur respectively and sometimes both of them may occur together. The intensity and duration of most of these reactions do not match with the criteria for anxiety disorders and depression. Anxiety is a common symptom of depression that involve 90% of patients. This complex disorder implies that psychological damage made in these patients develops from the anxiety to depression and their mental status remain unstable. Symptoms as anxiety and depression syndrome and some symptoms of autonomic nervous system may involve in the disorder. [3]

Child's deafness is one of the physical disorders that is effective in the mother's mental status as a stress. Hearing loss means a decrease in understanding sounds and is one of the most common congenital defects in infants that is never to be seen but is a severe disability and yet hidden. One out of every 750 babies is born with hearing loss [4] and there are 125 million deaf in the world that 100 000 of them are living in Iran. [5] Sensorineural hearing loss is a kind of deafness in which cochlear (sensory) or auditory branch of nerve VIII are damaged. Auditory communication is the base of maternal-infant bonding followed by learning, language and speech development. [6],[7]

Several previous studies about the stress levels in parents of children with an acute or chronic disease estimated that the prevalence of mental disorders in mothers of children with chronic diseases is 15 < 100%. [8],[9],[10],[11] Few studies in this field were done in Iran about mental disorders in mothers of children with deafness. In this paper we aimed to assess the prevalence of depression and anxiety in mothers of children with bilateral sensorineural hearing loss.


  Materials and Methods Top


This analytical cross-sectional study was conducted on 59 mothers of children with diagnosis of profound sensorineural hearig loss (approved by ABR and OAE tests) who were referred to Baghiyatallah univesity hospitals in 2009.

The profound bilateral sensorineural hearing loss was hearing loss more than 75 dB. [11] The mothers selected did not have the exclusion criteria in this study. Exclusion criteria were: Any current known psychiatric disorders or history of it, medications on mood, the presence of any acute stress in life or acute and important medical diseases in the children, mother or other family memebers.

The questionnaires were given to the mothers of children with deafness. It included maternal demographic information such as age, education, job, etc. It was the second edition of Beck's depression and anxiety questionnaire. The Cronbach's and final coefficients were calculated in the Iranian samples as 0.91 and 0.94, respectively. The intensity and rate of depression and anxiety are shown in [Table 1]. The Beck Anxiety Inventory (BAI) consists of 21 questions about the feeling in the last week that is evaluating the common symptoms of anxiety (such as numbness and tingling, sweating not due to heat, and fear of the worst happening). [12],[13] Each question has the same set of four possible answer choices, the BAI has a maximum score of 63 and the total score is arranged as:

0-7: Minimal level of anxiety

8-15: Mild anxiety

16-25: Moderate anxiety

26-63: Severe anxiety
Table 1: Description of severity of anxiety and depression

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The original Beck Depression Inventory (BDI) consisted of 21 questions about how the subject has been feeling in the last week. [12],[14] Each question has a set of at least four possible answer choices, ranging in intensity. The standard cut-offs are as follows:

0-9: Indicates minimal depression

10-18: Indicates mild depression

19-29: Indicates moderate depression

30-63: Indicates severe depression.

We used SPSS, 17th, with statitical frequency to express prevalence and Chi-square, T and ANOVA tests to evaluate the variance. All informations will remain confidential. Regarding to our policy in Baqiyatallah University, the informed consent was taken before the study. We marked the questionnaire with ID codes to make them unavailable for others. Moreover, this project was approved by ethic and scientific committee of Baqiyatallah University of medical sciences, Tehran, Iran.


  Results Top


There were 59 mothers with the mean age of 29.42 ± 4.39 years (between 22 to 38 years) and the mean age of children was 18.31 ± 4.72 months (between 12 to 35 months). The average time past from the diagnosis of deafness was 4.77 ± 9.43 months. Other demographic characteristics of the sample include: 27 children (45.7%) were female and the rest of them, about 32 cases (54.3%) were male. Among mothers there were 34 educated (57.6%) and 25 cases under graduate diploma. Forty-six cases, equal to 77.9%, lived in cities and the rest of them in suburbs. A total of 19 cases (32.2%) were mothers with 1 child, 34 cases (57.6%) with 2 children and 6 cases (10.1%) with more than 2 children. Prevalence of depression and anxiety among mothers were 39 (66.10%) and 47 (79.66%) cases, respectively. The mean depression score was 18.94 with a standard deviation equal to 8.95. About depression, the cases consisted of 20 people, equal to 33.89%, without depression, 12 people equal to 20.33%, with mild depression, 17 people equal to 28.81% with moderate depression and 10 people equal to 16.94% with severe depression. The mean anxiety score was 15.65 with a standard deviation equal to 10.29. About anxiety, the cases consisted of 12 people equal to 20.33% without anxiety, 27 people equal to 45.76% with mild anxiety, 12 people equal to 20.33% with moderate anxiety and 8 people equal to 13.55% with severe anxiety. There were no significant correlations between maternal depression or anxiety and following parameters: Maternal age (P:0.422), child's age (P:0.059), child's sex (P:0.619), time of diagnosis of child's deafness (P>0.05), parent's education (P:0.577), housing (P:0.368), mother's job status (P:0.603), family incomes (P:0.490), urban or rural habitancy (P:0.732) and parent's family relationship (P:0.422).


  Discussion Top


Prevalence of depression and anxiety in mothers of children with profound SNHL was 66.10% and 79.66%, respectively, in the present study it is more than in western studies. This may be due to lack of information and lower socio-economic levels of the subjects in the present study. Many previous studies were concerned about the prevalence of anxiety and depression in parents of children with acute or chronic diseases. In a German study involving 154 parents of children with hearing loss, nearly all were suffering from the stress induced by the children's illness. [7] They evaluated their cases by using Family climate scale (FKS) and Questionnaire for self-assessment of parental emotional state. The aim and usage of these questionnare are for assessing the stress level which is deferent with the aim of our study. Another study in the United States on 152 mothers showed that mothers of children with hearing loss, diagnosed more than 60 months ago were more stressed than the mothers of children with diagnosis in less time and these results are consistent with our findings. [8] Also a study in Freiburg on 124 parents of deaf children showed that quality of their life decreased significantly. No study was done about the prevalence of depression in mothers, so there were no differences with this study. [9] In another study, about quality of life for parents of children who underwent cochlear implantation surgery, it was shown that among 87 parents, most of them were stressed at the time of diagnosis and 25% of them developed with mental disorders which needed to be followed. [10]

In a study in Germany on 100 mothers of children with hearing disorders, prevalence of depression was significantly high in comparison with control group (11% compared with 2.5% for control group). Though there were no significant changes in prevalence of anxiety, however their quality of life scores decreased and became lower than patients with depression in this study. The severe depression rates in the present study are more than total depression rates in the above study, which may be related with cultural differences between two communities. [15] Another reason could be the different methods of assessment of depression viz. Hospital Anxiety and Depression Scale (HADS) in the earlier study while we used Beck anxiety and depression inventory.

In a study in Isfahan about the prevalence of depression in 200 mothers of children with two chronic diseases of asthma (27%) and diabetes (30%) in comparison with control group (16%), it is observed that there were no significant differences between the two groups with chronic diseases and the control group of children without any chronic diseases. And there was a difference in the prevalence of depression before and after the diagnosis of chronic diseases in the two groups (21% in the group of parents of children with asthma and 15% in the group of parents of children with diabetes). [16] This difference in prevalence of maternal depression between two studies can be explained by the higher disabilitities and social complications in hearing loss than the other chronic diseases of children. In addition, the stress of caring for a child with significant developemetal delay caused by congenital deafness, puts the mother at risk of depression. On the other hand, it is believed that maternal depression or anxiety disorders may have negative effects on the growth of children. Parent's reactions, early after the diagnosis of child's hearing loss such as sadness and denial may decrease helpful interventions and this is harmful to the child. Decrease in parent's involvement because of weak emotional performance can lead to adverse effects on cognitive and socioemotional development of deaf children. Therefore, regarding to the high efficacy of cochlear implantation as the main rehabilitation protocol for these children with SNHL, [17],[18] this treatments can be helpful to decrease the stress, anxiety and depression disorders that previously reported.

There are some limitations with this survey; this study is a small sample with purposive sampling method. Despite the validity of Beck's questionnaire, motivational responses can be influenced by different individuals. Depression and anxiety in many cases shows the need for psychiatric screening. The high prevalence of psychiatric disorders compared to the general population is matter of concern and more studies with larger samples are needed. Another limitation of this study is lack of a control group.


  Conclusion Top


Finally, depression and anxiety in mothers of children with profound sensorineural hearing loss have a high incidence of depression and anxiety. Psychological complications in the mothers of children with hearing loss should also be identified and treated while treating these children.


  Acknowledgment Top


We are grateful to the mothers of deaf children participated in this study. We also thank Mrs. Hasanalifard for her kindly cooperation.

 
  References Top

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  [Table 1]


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