The role of family functioning and self-esteem in the quality of life of adolescents referred for psychiatric services: a 3-year follow-up

Abstract

Purpose To investigate, in adolescents referred for psychiatric services, the associations of initial self-esteem and family functioning with level and change of quality of life (QoL) over a 3-year period, over and above the effect of their emotional problems. Methods Of 1648 eligible 13-18 years old patients attending the child and adolescent psychiatric clinic (CAP) at least once, 717 (54.8% females) were enrolled at baseline (a response rate of 43.5%). Self-and parent reports on the McMaster Family Assessment Device were obtained. Adolescents reported self-esteem on the Rosenberg Scale, and emotional problems on the Symptom Check List-5. Adolescents completed the Inventory of Life Quality in Children and Adolescents (ILC). After 3 years, 570 adolescents again completed the ILC, and for 418 adolescents parent information was available. The longitudinal analysis sample of 418 adolescents was representative of the baseline sample for age, gender, emotional problems, and QoL. We used modified growth-model analysis, adjusted for SES, age, gender and time of contact with CAP, where residual variances for ILC at baseline and follow-up were fixed to 0. Results A poorer family functioning at baseline, reported by parents, was significantly associated with worsening QoL during the 3 years follow-up period (p = 0.001). Conclusions Parents have important knowledge about their families that may reflect long-term influences on QoL development in adolescent psychiatric patients. Health care providers and policy makers should optimize treatment outcomes by addressing family functioning in adolescents with emotional problems.

Predictors of Quality of Life in Children and Adolescents with Psychiatric Disorders

“…It appeared that the positive effect of self-esteem on level of QoL was larger for boys than for girls. In the study of Bastiaansen et al [14] self-esteem has already been reported to be associated with QoL, but the present study showed that self-esteem might also be a predictor of QoL, although this findings was not confirmed by the Jozefiak et al study [12]. The findings suggest that strengthening the self-esteem of children with psychiatric problems may help to enhance their QoL over time.…”

“…However, an improvement of QoL was also reported in a number of children with persistently high levels of psychopathology [11], which suggests that QoL may improve, even if reduction of psychiatric symptoms is not achieved. A 3-year follow-up study of adolescents by Jozefiak et al [12] demonstrated that poorer family functioning at baseline, reported by parents, was significantly associated with worsening QoL during follow-up period. The other 1 3 factors included, Time 1 adolescent reports of anxious/ depressed symptoms and self-esteem, were not associated with change of QoL over the follow-up period.…”

Internet Addiction among Young Adult University Students: The Complex Interplay between Family Functioning, Impulsivity, Depression, and Anxiety

“…Among self-regulation problems, significant associations between IA and personality characteristics-especially impulsivity traits [48]-were found, which, in turn, have been shown to be significant associated with psychopathological problems, including anxiety and depressive symptoms [49][50][51]. Interestingly, it has been evidenced that the poor quality of family functioning may represent a significant contributing factor for the development of both young adults' psychiatric symptoms [52][53][54] and impulsivity problems [55], which, in turn, may play a mediating role on the relationship between the quality of family relationships and young adults' IA [56].…”

The role of mental health symptomology and quality of life in predicting referrals to special child and adolescent mental health services

“…Furthermore, there has been little work conducted on how quality of life, especially young people’s self-rated quality of life, may relate to help seeking or the recognition of need by adult caregivers. A few longitudinal studies have examined mental health symptoms and environmental variables as predictors of adolescent rated quality of life, showing an expected association between both poorer family function, higher symptom severity and lower quality of life [ 14 , 15 ]. However, as far we are aware, no studies have examined the longitudinal effect of quality of life on access to CAMHS that the conventional symptom measures may not capture, alongside baseline mental health symptoms and whilst taking into account other potential confounders including education attainment, school environment and family characteristics.…”