Peer-reviewed article
Psychosocial outcomes and related factors in adolescents using clean intermittent catheterization.
Menteşe Babayiğit T, Efendi GY, Babayiğit M, Çıkılı Uytun M, Akıncı A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined psychological and social well-being in 25 adolescents aged 12-18 years who perform clean intermittent catheterization (CIC) for urinary tract dysfunction, compared to 25 healthy peers. Adolescents using CIC showed higher social avoidance, poorer peer relationships, and 32% met criteria for at least one psychiatric disorder. Negative parental attitudes, maternal mental health problems, the underlying medical condition, age when self-catheterization started, and dependence on others for catheterization were all linked to worse self-esteem, quality of life, and peer relationships. The authors recommend multidisciplinary support combining psychiatric, family, and psychosocial care for adolescents managing this condition.
Key points
- 32% of adolescents performing CIC met DSM-5 criteria for at least one psychiatric disorder, compared to the control group
- Adolescents with CIC showed significantly higher social avoidance and poorer peer relationships than healthy controls
- Negative parental attitudes and maternal mental health problems were significant predictors of lower self-esteem and reduced quality of life
- Age at self-catheterization initiation and dependence on another person for catheterization predicted worse psychosocial outcomes
- Authors recommend early identification of risk factors and multidisciplinary management including psychiatric and psychosocial support
Limitations
The study is cross-sectional, so causality cannot be established. The sample size is small (50 total) and the countries are not specified, limiting generalizability of findings to other adolescent populations with CIC.
Abstract
Background Clean intermittent catheterization (CIC) is an established treatment for lower urinary tract dysfunction and has been used across age groups with voiding problems due to various etiologies. Although medically safe and straightforward, CIC may create social and emotional challenges for adolescents and their caregivers. During adolescence, when autonomy and peer acceptance become central, the need for continuous catheterization in daily life and, at times, dependence on another person can be difficult to cope with and may affect psychological well-being and peer relations. This study aimed to examine factors associated with potential psychopathology, self-perception, peer relationship characteristics, and quality of life in adolescents performing CIC. Methods This prospective cross-sectional study included 50 adolescents aged 12-18 years: 25 performing CIC and 25 age and sex-matched healthy controls. Participants with intellectual disability, low mental capacity preventing comprehension of study procedures, or uncorrected vision/hearing deficits were excluded. Psychiatric diagnoses were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version DSM-5 (K-SADS-PL). Self-perception, quality of life, behavioral difficulties, and peer relationships were evaluated using the Piers-Harris Children's Self-Concept Scale, Pediatric Quality of Life Inventory, Strengths and Difficulties Questionnaire, and Peer Relationship Scale. Parental attitudes and caregivers' psychological symptoms were assessed using the Parental Attitude Research Instrument and the General Health Questionnaire-28. Statistical analyses were performed using SPSS version 23.0. Group comparisons were conducted using the independent samples t-test or Mann-Whitney U test as appropriate; categorical variables were analyzed with the Chi-square or Fisher's exact test. Multiple linear regression analysis was performed to identify independent predictors. A two-tailed p value <0.05 was considered statistically significant. Results The groups were similar in age, sex and sociodemographic characteristics. Adolescents performing CIC showed higher social avoidance and poorer peer relationships. Eight adolescents (32%) in the CIC group met criteria for at least one psychiatric disorder according to DSM-5. Negative parental attitudes, maternal mental disorders, primary etiology requiring CIC, age at self-catheterization initiation, and catheterization performed by another individual were identified as significant predictors of lower self-esteem, reduced quality of life, and poorer peer relationships. Conclusion CIC may have meaningful psychological and psychosocial effects on adolescents, influenced by clinical variables and parental factors. Early identification of risk indicators and strengthening of protective factors are essential. A multidisciplinary approach incorporating psychiatric, familial, and psychosocial components should be included in the management and follow-up of adolescents performing CIC.