PSYCHOSOCIAL FUNCTION DURING TREATMENT FOR FAMILIAL HYPERCHOLESTEROLEMIA

Objective. To determine whether children treated for familial hypercho lesterolemia (FH) have greater psychosocial dysfunction compared with their peers. Children. Children were 86 boys and 66 girls 7-16 years o f age attending a lipid clinic. They were screened and instructed to f ollow a diet low in saturated fat and cholesterol 18 months to 9 years earlier (mean, 4 years), and their mean dietary intake, estimated by a quantitative food frequency questionnaire, was within recommended li mits. One-fourth had lost a parent or had a parent who had had cardiov ascular disease due to FH (parental disease group). Methods. Results o f the Child Behavior Checklist, Teacher's Report Form, and Youth Self- Report were compared with a population sample. A semistructured interv iew, the Child Assessment Schedule, was administered to the children w ith FH and a well-functioning comparison group from the population (ep idemiologic cohort; n = 62). Results. Psychosocial scores were similar in the children with FH and the population sample. The Child Assessme nt Schedule showed that, compared with the epidemiologic cohort, child ren with FH did not have increased symptoms in any area of function, a nd scores for family, mood, and expression of anger were lower (less s ymptomatic). The prevalence of psychiatric diagnoses was 10%, which wa s not greater than expected. Children from the parental disease group had higher symptom scores in the areas of school and expression of ang er than the rest of the children with FH. Their mean Children's Global Assessment Score (CGAS, which gives average children scores of 70-79) was slightly lower (77 vs 79). Belonging to the parental disease grou p predicted a lower CGAS in multivariate regression analyses, as did m ale sex, parental divorce, and low parental educational level. These f actors explained up to 19% (95% confidence interval, 9%-31%) of the va riance in CGAS. Conclusions. We found that the prevalence of psychosoc ial dysfunction was not greater than expected in children treated for FH. Psychosocial function within the group was associated with the usu al demographic characteristics and with the loss or disease of a paren t, beyond the period of bereavement or immediately after the event.