120 https://oamjms.eu/index.php/mjms/index
Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2022 Jan 06; 10(B):120-123.
https://doi.org/10.3889/oamjms.2022.7992
eISSN: 1857-9655
Category: B - Clinical Sciences
Section: Endocrinology
Risk Factors for Psychosocial Disorders in Children with
Congenital Adrenal Hyperplasia during the COVID-19 Pandemic
Muhammad Faizi , Nur Rochmah* , Irwanto Irwanto , Irma Soelistiyo , Yuni Hisbiyah , Rayi Kurnia Perwitasari
Department of Child Health, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, East Java,
Indonesia
Abstract
BACKGROUND: Congenital adrenal hyperplasia (CAH) is a chronic disease that requires lifelong medical therapy;
thus, it has become a psychosocial stressor associated with mental, emotional, and behavioral disorders in children
and adolescents. The COVID-19 pandemic is also an additional stressor in addition to chronic physical illness,
biological factors, cognitive factors, environment, age, parental education, parents’ occupations, and family income.
AIM: Thus, in this study, we aim to analyze the risk factors for psychosocial disorders among children with CAH.
METHODS: This research was a cross-sectional study conducted from January to April 2021 at the Pediatric
Endocrinology Outpatient Clinic in Dr. Soetomo General Hospital in Surabaya. Data were collected through
interviews, questionnaires, and medical records and then analyzed through univariate and bivariate analyzes using
Chi-square test (Fisher’s exact test).
RESULTS: In total, 30 children were enrolled in this study, among which 8 (26.7%) had emotional disorders,
5 (16.7%) had behavioral disorders, and most (83.3%) did not have hyperactivity/attention disorders. It was found
that 8 children (26.7%) had problems with peer relationships, whereas most (83.3%) did not experience prosocial
disorders. Family income (p = 0.032, CI = 95%) and hyperactivity (p = 0.019, CI = 95%) were found to be signifcantly
correlated to conduct problems.
CONCLUSIONS: Family income, behavioral disorders, and hyperactivity/attention disorders were identifed as risk
factors for psychosocial disorders in children with CAH during the COVID-19 pandemic.
Edited by: Ksenija Bogoeva-Kostovska
Citation: Faizi M, Rochmah N, Irwanto I,
Soelistiyo I, Hisbiyah Y, Perwitasari RK. Risk Factors
for Psychosocial Disorders in Children with Congenital
Adrenal Hyperplasia during the COVID-19 Pandemic.
Open Access Maced J Med Sci. 2022 Jan 06; 10(B):120-123.
https://doi.org/10.3889/oamjms.2022.7992
Keywords: Congenital adrenal hyperplasia; Risk factor;
psychosocial disorders, Children; COVID-19 pandemic
*Correspondence: Nur Rochmah, Department
of Child Health, Faculty of Medicine,
Dr. Soetomo General Hospital, Universitas
Airlangga, Surabaya, East Java, Indonesia.
E-mail: nur-r@fk.unair.ac.id
Received: 17-Nov-2021
Revised: 09-Dec-2021
Accepted: 27-Dec-2021
Copyright: © 2022 Muhammad Faizi, Nur Rochmah,
Irwanto Irwanto, Irma Soelistiyo, Yuni Hisbiyah, Rayi
Kurnia Perwitasari
Funding: This study was supported by the Director of Dr.
Soetomo General Hospital
Competing Interests: The authors have declared that no
competing interests exist
Open Access: This is an open-access article distributed
under the terms of the Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0)
Introduction
Congenital adrenal hyperplasia (CAH) is a
chronic disease that requires lifelong medical therapy;
it can possibly cause psychosocial problems such as
cognitive disorders, behavioral problems, depressive
tendencies, somatic disorders, and attention
disorders [1], [2]. Psychosocial problems in children
and adolescents are deemed to be quite serious
because they negatively impact their development,
productivity, and quality of life [3]. In addition to chronic
physical illness, psychosocial problems in children and
adolescents are also infuenced by biological/physical
factors, cognitive factors, environment, parental age,
parental education, parental occupation, and family
income [4].
During the COVID-19 pandemic, there are
massive restrictions on social activities, such as
schools being conducted online from home. There
is limited access to health services and disruption of
medicine distribution, thus making it difcult to visit
the hospital and take medication regularly. All of these
are additional stressors that may worsen psychosocial
disorders in children with chronic diseases such as
CAH [5].
Therefore, in this study, we aim to determine
the risk factors for psychosocial disorders in children
with CAH during the COVID-19 pandemic. Early
detection and intervention for these risk factors
have been determined to help prevent psychosocial
disorders.
Materials and Methods
The study population included pediatric
patients who had previously been diagnosed with CAH
and underwent outpatient treatment at the Pediatric
Endocrinology Outpatient Clinic in Dr. Soetomo
General Hospital during the COVID-19 pandemic
from January 1 to April 30, 2021. The sampling
method used was simple random sampling. Sample
size was calculated using Rosner with α of 5% [6].
The questionnaire used was strength and difculties