Psychopathology common in hearing-impaired young people

By Reuters Staff

Hearing-impaired children and adolescents are at risk for depression and behavior problems, but early intervention may offer some protection against psychopathology, according to a review of relevant research.

However, in a paper online today in JAMA Pediatrics, the reviewers acknowledge that the literature on psychopathology in hearing-impaired children and adolescents is "scarce and sometimes inconsistent."

Dr. Stephanie Theunissen from Leiden University in The Netherlands and colleagues investigated psychopathology in children and adolescents with bilateral hearing loss of at least 40 dB in the best ear, by reviewing 35 studies.

The literature "consistently" demonstrates that hearing-impaired children and adolescents are more prone to depression, aggression, oppositional defiant disorder, conduct disorder, and psychopathy than their normally hearing peers, the researchers say.

Some hearing-impaired young people may also experience elevated levels of anxiety, somatization, and delinquency. Whether hearing-impaired children suffer higher or lower levels of ADHD than their normal-hearing peers remains unclear.

The influence of type of hearing device on psychopathology is also uncertain. Only a few studies have investigated the effect of the type of hearing device on psychopathology, with some evidence that Cochlear implants can protect against psychopathology, the researchers report.

"Although it is plausible that the greater the degree of hearing loss is, the more psychopathology occurs, this hypothesis appears to be incorrect. Most literature found no influence of the degree of hearing loss on psychopathology," they say.

"Apparently other factors are more important for the prediction of psychopathology. For example, age at detection and age at intervention of hearing loss were essential; early detection and intervention of a child's hearing loss have been related to lower levels of psychopathology," they report.

The literature also shows that several specific forms of etiology of hearing loss, such as rubella or prematurity, as well as various syndromes, have been associated with more psychopathology. The risk of psychopathology also increases when hearing loss is associated with central nervous system disorders or when additional disabilities are present.

The literature also pinpoints several sociodemographic factors affecting psychopathology in hearing-impaired young people. Several studies relate older age to more psychopathology, except for anxiety because younger children tend to be more anxious than older children. Also, hearing-impaired girls experience more internalizing symptoms than hearing-impaired boys, particularly depression and anxiety, while boys experience more externalizing symptoms.

The type of school also appears to be relevant, with children attending special schools for deaf children exhibiting more psychopathology than hearing-impaired children attending mainstream schools. They seem to view themselves in a less favorable light than children in regular schools, the authors note.

Based on their review, Dr. Theunissen and colleagues say more studies are needed to "define a more precise occurrence of psychopathology" in hearing-impaired children. "These studies should have a longitudinal design to draw firmer conclusions on causality. Hopefully, this will lead to more knowledge in the future to help and support each hearing-impaired individual," they conclude.

The authors did not respond to request for comment by press time.

SOURCE: http://bit.ly/1cVpPGb

JAMA Pediatr 2013.

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