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Continuity of mental disorders in children with chronic physical illness

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Abstract

Data on the chronicity of mental disorder in children with chronic physical illness (CPI) are limited. We examined the prevalence and predictors of homotypic and heterotypic continuity of mental disorder in children with CPI. A sample of 263 children aged 2–16 years with physician-diagnosed CPI were recruited from outpatient clinics (e.g., dermatology, respiratory) at a Canadian pediatric academic hospital and followed for 24 months. Parent and child-reported mental disorders (mood, anxiety, behavioral, attention-deficit hyperactivity disorder [ADHD]) were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents at baseline, 6, 12, and 24 months. Marginal regression models were computed to identify clinical, parent, and demographic factors associated with mental comorbidity over time. Mental disorder was observed in 24–27% of children with CPI based on child reports and 35–39% based on parent reports. Parent-reported models revealed significant homotypic continuity for all mental disorders (ORs = 4.2–9.5), and heterotypic continuity between mood and anxiety disorders (OR = 2.2), ADHD and behavioral disorders (OR = 5.1), and behavioral and each mental disorder (ORs = 6.7–8.4). Child-reported models revealed significant homotypic continuity for mood (OR = 8.8) and anxiety disorder (OR = 6.0), and heterotypic continuity between anxiety and mood disorders (OR = 12.4). Child disability (ORs = 1.3–1.5) and parent psychopathology (ORs = 1.2–1.8) were the most consistent predictors of both child- and parent-reported mental disorder over time. Mental comorbidity was prevalent and persistent in children with CPI with homotypic and heterotypic continuity common across informants. Child disability and parent psychopathology may be priority targets within integrated family-centered models of care to prevent mental comorbidity in children with CPI.

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Data availability

Research ethical approval for MY LIFE does not permit the public sharing of study data. However, requests to access data from the MY LIFE cohort should be made in writing by contacting the corresponding author by email to initiate discussions regarding potential research projects.

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Acknowledgements

The authors gratefully acknowledge the children, parents, hospital staff, and health professionals at McMaster Children’s Hospital without whose participation the MY LIFE study would not have been possible. We especially thank Jessica Zelman for coordinating the study.

Funding

This work is supported by the Canadian Institutes of Health Research grant number PJT-148602.

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Authors and Affiliations

  1. School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada

    Mark A. Ferro & Christy K. Y. Chan

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada

    Ellen L. Lipman & Ryan J. Van Lieshout

  3. Jacobs Center for Productive Youth Development, Zurich, Switzerland

    Lilly Shanahan

  4. Pediatric Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, The Netherlands

    Jan Willem Gorter

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  1. Mark A. Ferro
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  2. Christy K. Y. Chan
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Contributions

MF conceptualized and designed the study, obtained funding, coordinated and supervised data collection, assisted with data analysis, and critically reviewed and revised the manuscript for important intellectual content. CC managed and organized the dataset, carried out the analyses, drafted the initial manuscript, and critically reviewed and revised the manuscript for important intellectual content. EL, RVL, LS, and JWG contributed to the study design and selection study measures, obtained funding, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Mark A. Ferro.

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Ethical approval

This study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the University of Waterloo Human Research Ethics Board (#31010).

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Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

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Ferro, M.A., Chan, C.K.Y., Lipman, E.L. et al. Continuity of mental disorders in children with chronic physical illness. Eur Child Adolesc Psychiatry (2024). https://doi.org/10.1007/s00787-024-02420-y

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