YOUNG-ADULTS WITH (ALPHA)1-ANTITRYPSIN DEFICIENCY IDENTIFIED NEONATALLY - THEIR HEALTH, KNOWLEDGE ABOUT AND ADAPTATION TO THE HIGH-RISK CONDITION

The psychological and psychosocial consequences of screening for alpha (l)-antitrypsin deficiency (alpha(1)ATD) were investigated when the su bjects were 5-7 years old. The present study was conducted when the su bjects were 18-20 years old, the foci of interest being their health, psychosomatic problems, knowledge about alpha(1)ATD and the potential effect of that knowledge on their lives and future family planning. Sa mples of 61 PiZ and 61 demographically matched control subjects, 18-20 years old, were asked to participate. Written, structured questionnai res covered the following items: basic familial characteristics, psych osomatic symptoms, opinions on medical check-ups, information and view s on future alpha(1)ATD screening, whether the knowledge about alpha(1 )ATD had affected the life and family planning of alpha(1)ATD individu als. Items concerning the ''alpha(1)ATD matter'' were excluded in the questionnaires given to the controls. Questionnaire data were obtained from 50 alpha(1)ATD and 48 control individuals, 41 of each being matc hed alpha(1)ATD-control pairs. No significant differences were found i n demographic or educational backgrounds, psychosomatic complaints suc h as headache, sleep difficulties, stomach ache, tiredness or anxiety. Lung symptoms occurred more frequently in alpha(1)ATD subjects (p = 0 .05). Six per cent of the alpha(1)ATD individuals planned working care ers with a high risk of air pollution. The majority (86%) of the alpha (1)ATD subjects perceived the contact with the medical services as pos itive; 14% as both positive and negative. The information concerning a lpha(1)ATD was assessed as satisfactory by 73%, as both good and bad b y 17% and as unsatisfactory by 10%. All alpha(1)ATD subjects advocated general screening for alpha(1)ATD, the neonatal period being chosen a s optimal by 94%. Half of the alpha(1)ATD individuals thought that the knowledge of their high-risk condition had affected their lives, part icularly their awareness of the dangers of smoking and environmental p ollution. The majority, 88%, knew that they should avoid smoking to pr otect their lungs. In conclusion, no negative psychosocial consequence s of the neonatal alpha(1)AT-screening were found in early adulthood. The alpha(1)ATD individuals were aware of the dangers of smoking and w ere of the opinion that alpha(1)AT-screening should be recommended.