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      Depression, Anxiety, and Perceived Social Support among Adults with Beta-Thalassemia Major: Cross-Sectional Study

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          Abstract

          Background

          Considering the high prevalence of depression and anxiety among thalassemia patients and the role of social support in preventing mental disorders, this study aimed to determine prevalence of depression, anxiety, and perceived social support (PSS) among adults with beta-thalassemia major.

          Methods

          This cross-sectional study was performed with 389 adults with beta-thalassemia major. Data were collected via a questionnaire consisting of three parts: demographic and medical information, the Persian version of the hospital anxiety and depression scale, and the Persian version of the Multidimensional Scale of Perceived Social Support. Data were analyzed using IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) through analytical statistics (independent-samples t-test, one-way analysis of variance, Pearson correlation coefficient, and multilevel linear regression), and the results less than 0.05 were considered to be significant.

          Results

          The mean scores of depression, anxiety, and PSS of patients were 7.42±3.17, 7.47±4.35, and 41.8±8.64, respectively. Of 389 patients, 19.8% had depression and 23.7% had an anxiety disorder. Relationships of depression and anxiety with age, the level of education, job, and family income were statistically significant, as were those of PSS with age, thalassemia center, family income, job, and the level of education. PSS from family, friends, and significant others were the significant predictive factors of depression and anxiety among adult patients with beta-thalassemia major.

          Conclusion

          Considering the PSS as a factor influencing the reduction in depression and anxiety in thalassemia patients, social support from the social networks (spouse, family members, friends, and healthcare workers) should be integrated with interventions that are designed to improve the mental and physical health of thalassemia patients.

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          Most cited references23

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          The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version

          Background The Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients. This study aimed to translate and test the reliability and validity of the Iranian version of the HADS. Methods The English language version of the HADS was translated into Persian (Iranian language) and was used in this study. The questionnaire was administered to a consecutive sample of 167 breast cancer patients and statistical analysis was performed to test the reliability and validity of the HADS. Results In general the Iranian version of the HADS was found to be acceptable to almost all patients (99%). Cronbach's alpha coefficient (to test reliability) has been found to be 0.78 for the HADS anxiety sub-scale and 0.86 for the HADS depression sub-scale. Validity as performed using known groups comparison analysis showed satisfactory results. Both anxiety and depression sub-scales discriminated well between sub-groups of patients differing in clinical status as defined by their disease stage. Conclusion This preliminary validation study of the Iranian version of the HADS proved that it is an acceptable, a reliable and valid measure of psychological distress among cancer patients.
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            Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents.

            The psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) were investigated in 222 urban, largely African-American adolescents (68%). High internal consistency was demonstrated, and factor analysis confirmed the three subscale structures of the MSPSS: family, friends, and significant other. Correlations with a family caring scale supported the discriminant validity of the Family subscale. These results confirm the reliability, validity, and utility of the MSPSS with an urban, largely African-American adolescent sample. Implications of the findings are discussed.
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              • Article: not found

              α-Globin as a molecular target in the treatment of β-thalassemia.

              The thalassemias, together with sickle cell anemia and its variants, are the world's most common form of inherited anemia, and in economically undeveloped countries, they still account for tens of thousands of premature deaths every year. In developed countries, treatment of thalassemia is also still far from ideal, requiring lifelong transfusion or allogeneic bone marrow transplantation. Clinical and molecular genetic studies over the course of the last 50 years have demonstrated how coinheritance of modifier genes, which alter the balance of α-like and β-like globin gene expression, may transform severe, transfusion-dependent thalassemia into relatively mild forms of anemia. Most attention has been paid to pathways that increase γ-globin expression, and hence the production of fetal hemoglobin. Here we review the evidence that reduction of α-globin expression may provide an equally plausible approach to ameliorating clinically severe forms of β-thalassemia, and in particular, the very common subgroup of patients with hemoglobin E β-thalassemia that makes up approximately half of all patients born each year with severe β-thalassemia.

                Author and article information

                Journal
                Korean J Fam Med
                Korean J Fam Med
                KJFM
                Korean Journal of Family Medicine
                The Korean Academy of Family Medicine
                2005-6443
                2092-6715
                March 2018
                22 March 2018
                : 39
                : 2
                : 101-107
                Affiliations
                [1 ]Reproductive Health Research Center, Department of Public Health, School of Health, Urmia University of Medical Sciences, Urmia, Iran.
                [2 ]Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
                [3 ]Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
                [4 ]Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
                Author notes
                Corresponding Author: Davoud Shojaeizadeh. Tel: +98-21-42933211, Fax: +98-21-88989129, shojae5@ 123456yahoo.com
                Author information
                https://orcid.org/0000-0003-2730-4795
                Article
                10.4082/kjfm.2018.39.2.101
                5876044
                29629042
                d4887f9e-6b62-4d55-9620-73aac060383a
                Copyright © 2018 The Korean Academy of Family Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 April 2017
                : 22 April 2017
                : 08 May 2017
                Categories
                Original Article

                Medicine
                depression,anxiety,social support,beta-thalassemia
                Medicine
                depression, anxiety, social support, beta-thalassemia

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