Mental health of patients with adolescent idiopathic scoliosis and their parents in China: a cross-sectional survey

BACKGROUNDS: Adolescent idiopathic scoliosis (AIS) is an adolescent onset spinal deformity, which can negatively affect the mental health of these patients. But no studies about their parental mental health have been reported so far. In this study, the parental mental health of AIS patients and the associated risk factors were evaluated by a cross-sectional survey. METHODS: 64 AIS patients who underwent conservative or surgical treatments in our hospital from April 2017 to March 2018, and their parents were enrolled in the AIS group. 85 parents of healthy children were enrolled in the control group. Depression and anxiety were separately assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item scale (GAD-7). Spearman correlation coefficients were first estimated to investigate the relationships among the parental PHQ-9/GAD-7 scores and the patient's PHQ-9/GAD-7 scores in the AIS group. Then, the morbidities of the parental probable major depressive disorder (pMDD, PHQ score ≥ 10) and probable general anxiety disorder (pGAD, GAD-7 score ≥ 10) were compared between the AIS and control groups. Third, the potential risk factors for parental pMDD or pGAD in the AIS group were compared using the chi-squared test or Student's t-test, respectively. Finally, the uneven distributive variates were analyzed using the binary logistic regression model. RESULTS: Both parental depression and anxiety were moderately associated with those of the patients (r = 0.448~0.515, p < 0.01) in the AIS group, respectively. The morbidities of parental pMDD and pGAD in the AIS group were 14.1%, significantly higher than those in the control group (pMDD = 4.7%, p = 0.045; pGAD = 3.5%, p = 0.019). A Cobb angle of the major curve ≥50° (p = 0.034, odds ratio [OR] = 8.264), patients with pMDD (p = 0.018, OR = 17.576), and low education level of the parents (p = 0.026, OR = 0.122) were the risk factors of parental pMDD. Household income < 8000 rmb/month was the risk factor for parental pGAD (p = 0.021). CONCLUSIONS: The morbidities of pMDD and pGAD in parents of AIS patients were higher than those in parents of healthy children. Parental depression and anxiety were closely associated with their children's depression and anxiety. Therefore, the parental mental health of AIS patients should be paid attention to, especially for those parents with risk factors.