Increased internalising and externalising behavioural problems associated with corticosteroid usage in children with nephrotic syndrome: a South East Asian perspective

Abstract

Introduction: The study was performed to measure psychological problems in children with idiopathic nephrotic syndrome (INS) while on steroid therapy as compared to healthy children. Methods: It was a prospective cohort study conducted in a paediatric clinic of a tertiary hospital. Parents of participants, both in the INS group and the control group comprising children without chronic illness, were asked to complete questionnaires using the Child Behavioral Checklist (CBCL). CBCL measures a range of age-specific emotional and psychological problems including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test. Results: A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between INS group children and control group children, specifically in the withdrawal, somatic, anxious, and aggressiveness sub-domains. Similar findings were demonstrated in a correlation between total psychological problems with the dosage of corticosteroid. Within the INS children, steroid dose and Cushingoid features were found to have a significant positive association with internalising psychological problems. Conclusion: Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores compared to healthy children.