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Onset of Psychopathology Among Children With Chronic Physical Illness
Melissa Elgie1, Jennifer Yessis1, Dillon T Browne2
1School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Insights
Many children with chronic physical illness (CPI) develop psychopathology. Greater disability, older age, and younger parents increased internalizing risk, while male sex and parent psychopathology increased externalizing risk.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Longitudinal Health Studies
Background:
- Children with chronic physical illness (CPI) face heightened risks for developing psychopathology.
- Existing research on psychopathology onset in this population is limited and often illness-specific.
- This study investigated the onset and contributing factors of internalizing and externalizing psychopathologies in children with CPI over a 48-month period.
Purpose of the Study:
- To examine the incidence and timing of internalizing and externalizing psychopathology onset in children with CPI.
- To identify predictors associated with the development of these psychopathologies.
- To inform targeted interventions and support for vulnerable children with CPI.
Main Methods:
- A longitudinal study involving 263 children (aged 2-16 years) with CPI and their parents.
- Parent-reported Mini International Neuropsychiatric Interview for Children and Adolescents used to identify psychopathology onset.
- Kaplan-Meier survival analyses and Cox regression models were employed to analyze onset and predictors.
Main Results:
- A significant majority (64.1%) of children experienced internalizing or externalizing psychopathology during the study.
- Average time to onset was approximately 20.4 months for internalizing and 18.1 months for externalizing psychopathology.
- Predictors for internalizing psychopathology included greater disability, older age, and younger parental age. Male sex and higher parental psychopathology predicted externalizing psychopathology.
Conclusions:
- A substantial proportion of children with CPI develop psychopathology, highlighting a critical need for mental health support.
- Specific subgroups, such as those with greater disability or parental psychopathology, are at higher risk.
- Routine mental health screening for children with CPI is recommended to promote their overall well-being.
Background:
Children with chronic physical illness (CPI) are highly vulnerable to developing a co-occurring psychopathology, which is associated with compounding negative health effects throughout the life-course. Literature regarding psychopathology onset among children with CPI is sparse; studies are predominantly cross-sectional and illness-specific. This research examined the onset and correlates of internalising and externalising psychopathologies among children with CPI over 48 months.
Methods:
Data come from a longitudinal study of 263 children with CPI, aged 2-16 years, and their parent. Child psychopathology was measured using the parent-reported Mini International Neuropsychiatric Interview for Children and Adolescents, which defined the events, internalising and externalising psychopathology onset. Kaplan-Meier survival analyses illustrated internalising and externalising psychopathology onset, and Cox regressions modelled predictors of onset.
Results:
Overall, 64.1% of children met criteria for an internalising or externalising psychopathology at baseline and throughout follow-up. Average time-to-onset of internalising and externalising psychopathology was approximately 20.4 and 18.1 months, respectively. Children with greater disability (HR = 1.15, 1.00-1.31), were older (HR = 1.15, 1.05-1.27), and had younger parents (HR = 0.91, 0.85-0.97) were most susceptible to an internalising psychopathology. Male children (HR = 0.37, 0.20-0.70), and children exposed to greater parent psychopathology (HR = 1.29, 1.11-1.47) were most likely to develop an externalising psychopathology.
Conclusions:
Many children with CPI developed psychopathology, and subgroups of children were identified as most at risk of internalising and externalising psychopathology. Findings support routine mental health screening of children with CPI to foster mental well-being among these vulnerable children.
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