Chronicity of mental comorbidity in children with new‐onset physical illness

Abstract

Background: Evidence suggests that physical and mental illnesses are strongly correlated in children. This study examined patterns of the chronicity of multimorbidity (co-occurring physical and mental illness); estimated homotypic continuity; and modelled factors associated with chronicity in children newly diagnosed with a chronic physical illness.Methods: Children aged 6-16 years diagnosed with one of asthma, diabetes, epilepsy, food allergy, or juvenile arthritis were recruited from two children's hospitals and followed for 6 months. Child mental illness was measured using the parentreported Mini International Neuropsychiatric Interview and Ontario Child Health Study Emotional Behavioural Scales at baseline and 6 months later. Children were stratified into three groups: no multimorbidity, acute (multimorbidity at only one assessment), and persistent (multimorbidity at both assessments).Results: Forty-nine children were available for analysis: no multimorbidity (n = 18), acute (n = 13), and persistent (n = 18). Homotypic continuity was highest for conduct disorder (67.5%) and lowest for major depression (16.7%). Unadjusted analyses showed positive associations between child and parent behavioural symptoms, as well as family functioning with persistent multimorbidity. These associations remained after adjustment, ranging from odds ratio (OR) = 1.29 [1.01, 1.64] for depression to OR = 1.61 [1.11, 2.33] and OR = 1.61 [1.10, 2.35] for attentiondeficit hyperactivity and oppositional defiant, respectively, in child models. In parent models, associations remained for parental anxiety (OR = 1.18 [1.04, 1.34]) and stress (OR = 1.15 [1.02, 1.31]).Conclusions: Multimorbidity is persistent in children newly diagnosed with physical illnesses, regardless of the mental comorbidity experienced. Integrating familycentred mental health services soon after the diagnosis of a physical illness should be prioritized in pediatric settings.

COVID-19-Related Psychological and Psychosocial Distress Among Parents and Youth With Physical Illness: A Longitudinal Study

“…Youth with rheumatological conditions self-reported elevated symptoms of anxiety compared with their peers (d = 0.33). No significant differences in mental health were reported across the different types of rheumatological conditions, consistent with pre-pandemic studies that support non-categorical approaches (21,22) to understanding the intersection between physical and mental illness in children and youth (23)(24)(25)(26)(27). Notably however, studies have showed that clinical factors such as illness duration, severity, or exacerbations during the pandemic have no or minimal association with COVID-19-related mental health among youth with physical illness (16,20).…”

Physical-mental multimorbidity in children and youth: a scoping review

“…An estimated 15% of all children will experience the co-occurrence of at least one physical illness and at least one mental disorder—defined as physical-mental multimorbidity . 19 Physical-mental multimorbidity is often chronic and has been shown to be associated with significant negative impacts on daily functioning, 20 21 increases in mental health service use 22 and greater likelihood of suicidality 23 and risky substance use 24 25 among youth. However, despite increased interest in child mental health in recent decades as well as modern advancements in healthcare for children with physical illnesses, research on child physical-mental multimorbidity remains limited.…”

Get Outside! Promoting Adolescent Health through Outdoor After-School Activity

“…Rural-dwelling adolescents may have a greater burden of health risks compared to their urban counterparts, in part due to differences in health behaviors, economic disparities, and a lack of access to health-promoting services [ 4 , 5 ]. The onset of physical and mental health problems in adolescence can disrupt typical development and extend health risks into adulthood [ 6 ]. Establishing early, health-promoting behaviors is vital to mitigating health risks across the lifespan.…”