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Health Functioning Moderates the Association Between Chronic Conditions and Mental Illness in Childhood

Shannon V Reaume1, Joel A Dubin1,2, Christopher M Perlman1

  • 1School of Public Health Sciences, University of Waterloo, Waterloo, Canada.

Child: Care, Health and Development
|March 30, 2026
PubMed

Insights

Children with chronic conditions are more likely to experience mental illness, especially if they have better health functioning. This highlights the need for early screening and intervention to prevent physical-mental multimorbidity.

Area of Science:

  • Pediatric Health
  • Child Psychology
  • Public Health

Background:

  • Chronic conditions in children can impact their mental well-being.
  • Understanding the interplay between physical and mental health in pediatric populations is crucial.

Purpose of the Study:

  • To quantify the association between chronic conditions and mental illness in children.
  • To investigate moderating factors like health functioning and mediating factors like family functioning.
  • To explore the impact of chronic conditions on specific mental health outcomes such as anxiety and ADHD.

Main Methods:

  • Secondary data analysis of the 2014 Ontario Child Health Study (OCHS) involving 6242 children aged 4-17.
  • Assessment of chronic conditions using Statistics Canada standards and mental illness using the Emotional Behavioural Scales (EBS).
  • Logistic regression and interaction models were used to analyze associations, moderation, and mediation effects.

Main Results:

  • A chronic condition was associated with mood disorder (OR=2.25).
  • Children with chronic conditions and better health functioning showed increased likelihood of any mental illness (29%), anxiety disorders (21%), and ADHD (21%).
  • No association was found between chronic conditions and mental illness in children with poorer health functioning; family functioning did not mediate these associations.

Conclusions:

  • Health functioning significantly moderates the association between chronic conditions and mental illness in children.
  • Specific mental health conditions like anxiety disorders and ADHD are more prevalent in children with chronic conditions and better health functioning.
  • Routine mental health screening and early interventions are recommended for children with chronic conditions, particularly those with better health functioning, to address physical-mental multimorbidity.
Abstract

Keywords:
childrenchronic conditionshealth functioningmental illnessmultimorbiditypopulation healthsecondary analysis

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