The relationship between physical and mental health multimorbidity and children’s health-related quality of life

Abstract

Purpose To examine the relationships between physical health problems, and borderline or clinical levels of mental health symptoms and children’s health-related quality of life (HRQoL). Methods Data were from the Longitudinal Study of Australian Children (2004–2018). Parents reported on their child’s HRQoL (PedsQL), physical health problems and mental health symptoms (Strengths and Difficulties Questionnaire, SDQ). A pooled cross-sectional analysis using linear regressions examined the relationships between physical health and clinical/borderline mental health symptoms, individually and when multi-morbid, and children’s HRQoL, and whether these relationships vary by a range of child, family and social factors. Results The sample comprised 47,567 observations of children aged 4–17 years. Borderline and clinical levels of mental health symptoms were associated with significantly lower HRQoL, equal to more than two-times (10.5 points) and more than three-times (16.8 points) the clinically meaningful difference, respectively. This was a larger difference than that associated with physical health problems (4.4 points). We found a significant interaction effect between physical health problems and clinical mental health symptoms which was associated with even poorer HRQoL after accounting for the individual relationships of both problems. Mental health problems were associated with poorer HRQoL for older versus younger children; and the interaction effect was significant for boys but not girls. Conclusion Findings highlight the importance of identifying and addressing mental health symptoms in children of all ages, even if these problems do not meet formal clinical criteria. Particular attention should be paid to the mental health and HRQoL of children with physical–mental multimorbidity, who are at risk of disproportionately poorer HRQoL.

Internalizing and externalizing mental health problems affect in-school adolescent’s health-related quality of life in eastern Ethiopia: A cross-sectional study

“…The HrQoL was reduced by half among those with borderline and abnormal internalizing problems and a 40% reduction among those externalizing problems. This finding is supported by previous evidence in Nigeria [ 40 ], Kenya [ 41 ], Rotterdam [ 42 ], Australia [ 43 ], and in the United States [ 44 ], which revealed that the HrQoL of adolescents with mental health problems is strongly affected and functionally inferior even in comparison with adolescents with other health problems. One possible explanation for the strong association of internalization and externalization of mental health problems on HrQoL is that the internalization and externalization of mental health problems affect the functioning of adolescents in multiple ways.…”

“…The results showed that all chronic physical conditions were associated with poor HrQoL in adolescents. Previous studies have also reported that any chronic physical disorder affects HrQoL in adolescents [ 25 , 43 ]. The potential explanation for this association could be chronic physical disease can have a broad impact, including HrQoL, which measures the impact of a young person’s health on their everyday emotional, social and physical functioning [ 43 ].…”

“…Previous studies have also reported that any chronic physical disorder affects HrQoL in adolescents [ 25 , 43 ]. The potential explanation for this association could be chronic physical disease can have a broad impact, including HrQoL, which measures the impact of a young person’s health on their everyday emotional, social and physical functioning [ 43 ]. The impact can also affect their academic performance, limit social activities with peers, and reduce activities at home and with the family [ 52 ].…”

Investigation of the Associations between Diet Quality and Health-Related Quality of Life in a Sample of Swedish Adolescents

“…It is crucial to measure domains of health in adolescents to prevent more serious longterm conditions [17]. Lower health-related quality of life has been associated with high mental health symptoms in adolescents and therefore health-related quality of life should be explored in this population [18].…”

Measuring What Matters: Drawing on a Participatory Wellbeing Framework and Existing Data to Assess Child Wellbeing Outcomes Over Time

“…The LSAC data has been used extensively to explore various aspects of child wellbeing through longitudinal analysis (e.g. Howard & Williams, 2018;Mishra et al, 2017;O'Loughlin et al, 2022;Wang et al, 2019;Warren, 2017). For example, in developing a longitudinal multidimensional poverty index based on the UN Convention on the Rights of the Child, Mishra et al (2017) found that health and emotional wellbeing were the largest areas of concern, driven predominantly through poor body weight and bullying.…”