Mental disorder in children with physical conditions: a pilot study

Abstract

ObjectivesMethodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up.DesignProspective pilot study.SettingTwo children’s tertiary-care hospitals.ParticipantsChildren aged 6–16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents.Outcome measuresResponse, participation and retention rates. Child mental disorder using the Mini International Neuropsychiatric Interview at baseline and 6 months. Child quality of life, parental symptoms of stress, anxiety and depression, and family functioning. All outcomes were parent reported.ResultsResponse, participation and retention rates were 90%, 83% and 88%, respectively. Of the 50 children enrolled in the study, the prevalence of multimorbidity was 58% at baseline and 42% at 6 months. No sociodemographic characteristics were associated with multimorbidity. Multimorbidity at baseline was associated with declines over 6 months in the following quality of life domains: physical well-being, β=−4.82 (–8.47, –1.17); psychological well-being, β=−4.10 (–7.62, –0.58) and school environment, β=−4.17 (–8.18, –0.16). There was no association with parental psychosocial outcomes over time.ConclusionsPreliminary evidence suggests that mental disorder in children with a physical condition is very common and has a negative impact on quality of life over time. Based on the strong response rate and minimal attrition, our approach to study child multimorbidity appears feasible and suggests that multimorbidity is an important concern for families. Methodological and substantive findings from this pilot study have been used to implement a larger, more definitive study of child multimorbidity, which should lead to important clinical implications.

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

“…Details of the study methodology have been described elsewhere (Butler et al, ). Briefly, data come from a prospective pilot study assessing the mental health of children aged 6–16 years newly diagnosed with one of asthma ( n = 15), diabetes ( n = 9), epilepsy ( n = 8), food allergy ( n = 8), or juvenile arthritis ( n = 9) recruited from the respective outpatient clinics at two children's hospitals in Ontario, Canada.…”

“…Multinomial logistic regression was used to compute odds ratios (ORs) and associated 95% confidence intervals for characteristics associated with the chronicity of multimorbidity. Characteristics that were statistically significant were then included in multivariable models that adjusted for participant age and household income, as these factors are known to confound estimates of child psychopathology (Butler et al, ; Ferro & Boyle, ; Ferro et al, ). Parsimonious models with a minimum set of confounders were preferred given the relatively small sample size, which was based on previous guidelines for pilot studies (Hertzog, ).…”

“…Converging findings from recent population and clinical studies suggest that children, adolescents, and young people with chronic physical illnesses are disproportionately affected by mental illness compared with those without physical illness (Butler et al, ; Ferro, ; Tegethoff, Belardi, Stalujanis, & Meinlschmidt, ). Collectively, these studies have provided robust evidence that the risk for mental illness is similar across different physical illnesses (Ferro, ; Merikangas et al, ; Tegethoff et al, ; Tegethoff, Stalujanis, Belardi, & Meinlschmidt, ).…”

Anxiety and food allergy: A review of the last two decades

“…14 Among children with physical conditions, anxiety disorders (eg, separation anxiety, phobias or generalized anxiety) have been found the most common condition at diagnosis and 6 months later. 15 In FA, an appropriate level of anxiety may contribute to maintain vigilance and take appropriate precautions for allergens avoidance without inhibiting normal daily life. However, a sustained intense anxiety is considered maladaptive since it enhances the risk for increased burden and psychopathology.…”

Caracterización clínica y demográfica de la hospitalización psiquiátrica infantojuvenil en un hospital general

“…La presencia de trastornos psiquiátricos secundarios, relacionados con enfermedades médicas crónicas tal como se reporta, ha sido corroborada por otros (11) autores . En lo que respecta particularmente a la epilepsia como factor de riesgo para el desarrollo de (12) síntomas psiquiátricos Bilgiç y cols.…”