Determinant factors of depression in beta major thalassemia children


Abstract views = 369 times | downloads = 197 times


Thalassemia is a chronic disease with long-term treatment that increases the potential for impact on physical, cognitive, and psychological conditions. About 80% of patients with major thalassemia have at least one psychiatric disorder, depression is one of the most frequently reported, especially in prepubertal and puberty periods. The aim of this study is to evaluate determinant factors of depression in beta mayor thalassemia children. This was a cross-sectional study on patients aged 9 to 17 years at hematology outpatient clinic in Dr. Soetomo General Hospital from September to Desember 2018. Level of depression determinded by Children Depression Inventory (CDI) questionnaire. The data were collected and analyzed using using the IBM SPSS Statistics version 21. It is statistically significant with p<0.05. Forty-five participants were included in this study, 15 participants with mild depression and 30 participants without depression. Gender (p=0.462), age of diagnosis (p=0.385), frequency of tranfussion (p=0.065), family history of depression (p=0,350), physical change (p=0.711), duration of illness (p=0.674) have no significant value as a determinant factor while complication (p=0.049) and serum cortisol level (p=0.037) had significant value as determinant factors of depression in Beta Major Thalassemia children. Mild depression is more common in thalassemia patients who experience complications and had high serum cortisol levels


Beta Major Thalassemia; Level of depression; Children Depression Inventory

Full Text:



Aydinok Y, Erermis S, Bukusoglu N, Yilmaz D and Solak U (2005). Psychosocial implications of Thalassemia Major. Paediatr. Int.47(1):84-89.

Baldini M, Mancarella M, Cassinerio E, Marcon A, Ambrogio AG and Motta I (2017). Adrenal insufficiency: An emerging challenge in Thalassemi?. Am. J. Hematol. 92(6):E119-121.

Balbo M, Leproult R, Van Cauter E (2010). Impact of Sleep and Its Disturbances on Hypothalamo-Pituitary-Adrenal Axis Activity. International Journal of Endocrinology. 2010:1-11.

Behdani F, Badiee Z, Hebrani O, Moharreri F, Badiee AH, Hajivosugh (2015). Psychological Aspects in Children and Adolescents With Major Thalassemia: A Case-control Study. Iran. J. Pediatr. 25(3):e322.

Bulan, S (2009). Faktor-faktor yang berhubungan dengan kualitas hidup anak Thalassemia beta mayor [Tesis]. Program Pascasarjana Magister Ilmu Biomedik dan Program Pendidikan Dokter Spesialis Ilmu Kesehatan Anak. Universitas Diponegoro Semarang.

Bush S, Mandel FS and Giardina PJ (1998). Future orientation and life expectations of adolescens and young adults with Thalassemia Major. Ann N Y Acad Sci. 30;850:361-369.

Ghanizadeh A, Khajavian S, and Ashkani H (2006). Prevalence of psychiatric disorders, depression, and suicidal behavior in child and adolescent with Thalassemia Major. J. Pediatr. Hematol. Oncol. 28(12): 781-784.

Gladstone TR dan Beardslee WR (2009). The prevention of depression in children and adolescents: a review. Can J Psychiatry. 54: 212-21.

Hasting CA, Trorkildson JC and Agrawal AK (2012). Thalassemia. In : Handbook of Pediatric Hematology and Oncology: Children's Hospital & Research Center Oakland, Second edition. Wiley-Blackwell. pp 36-43.

Hoffbrand AV (2006). Thalassemia. In: Pediatric Hematology. Australia, Blackwell. 13: p281-299.

Khurana A, Katyal S, Marwaha RK (2006). Psychosocial burden in Thalassemia. Indian. J. Pediatr. 10: 877-880.

Mariani D (2011). Analisis faktor yang memepengaruhi kualitas hidup anak Thalassemia beta mayor di RSU Kota Tasilmalaya dan Ciamis. Jurnal Keperawatan Indonesia. 4(1): 1-10.

Mazzone L, Battaglia L, Andreozzi F, Romeo MA, Mazzone D (2009). Emotional impact in -Thalassemia major children following cognitive-behavioural family therapy and quality of life of ceregiving mothers. Clin. Pract. Epidemiol. Ment. Health. 5: 5.

Mednick L, Yu S, Trachtenberg F, Xu Y, Kleinert DA, Giardina PJ, Kwiatkowski JL, Foote D (2010). Symtoms of depression and anxiety in patients with Thalassemia: Prevalence and correlates in the Thalassemia longitudinal cohort. AM. J. Hematol. 85: 802-805.

Messina G, Colombo E, Cassinerio E, Ferri F, Curti R, Altamura C and Cappellini (2008). Psychosocial aspects and psychiatric disorders in young adult with Thalassemia Major. Intern. Emerg. Med. 3(4): 339-343.

Nasiri M, Hosseini H and Shahmohammadi S (2014). Mental health status in patients with Thalassemia major in Iran. J. Pediatr. Rev. 2: 55-61.

Nugraha D (2009). Faktor-faktoryang berhubungan dengan kualitas hidup pasien Thalasemia mayor. Sari. Pediatri. 11: 85-89.

Pattanashetti M, Mugali J, Patil S (2017). A study of severity of depression in Thalassemia patients. Int. J. Indian. Psychol. 4: 29-32.

Permono B and Ugrasena IDG (2006). Hemoglobin abnormal: thalasemia. Dalam: Permono B, Sutaryo P, Ugrasena IDG, Windiastuti E dan Abdulsalam M. (Editor): Buku Ajar Hematologi-Onkologi Anak. Badan Penerbit IDAI Jakarta.

Rodriguez-Velasco, Dominguez-alonso, Fenandez-Gonzalez, Villarubia J, Ropero P, Martinez-Nieto dan Fuente F (2014). How can we discriminate it from -Thalassemia Trait and Iron Deficiency Anemia. Am. J. Clin. Pathol. 142: 567-573.

Sarker RN Kumar S and Shahriar A (2017). Recent advances in the management of Thalassemia: A Review Update. 6:31.

Sharpe D (2002). Siblings of children with chronic illness: A meta analysis. J. Pediatr. Psychol. 27 699-710.

Sun S, Wang S (2014). The Children’s Depression Inventory in Worldwide Child Development Research: A Reability Generalization Study. J Child Fam Stud. 24: 2352-63.

Venty, Rismarini, Sari PS, Kesuma Y, Indra MR (2018). Depression in children with thalassemia major: prevalence and contributing factors. Paediatrica Indonesiana. 58;6: p.263-268.

Yengil E (2014). Anxiety, depression and quality of life in patients with beta thalassemia major and their caregivers. Int. J. Clin. Exp. Med. 7(8). 2165-72.


  • There are currently no refbacks.

Copyright (c) 2021 AHMAD SURYAWAN, Hapsari Widya Ningtiar, IRWANTO IRWANTO, I Dewa Gede UGRASENA

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Indexed By

View My Stats

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.