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Long-term psychosocial sequelae of chronic physical disorders in childhood
I B Pless1, C Power, C S Peckham
1Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
Insights
Children with chronic physical disorders face long-term psychosocial challenges, particularly men who experience higher risks of psychological distress and unemployment. These findings highlight the need for integrated care addressing the mental health of children with chronic conditions.
Area of Science:
- Child Health
- Psychosocial Medicine
- Longitudinal Studies
Background:
- Chronic physical disorders originating in childhood can have lasting effects.
- Understanding the long-term psychosocial impact is crucial for comprehensive care.
Purpose of the Study:
- To investigate the long-term psychosocial consequences of chronic physical disorders that begin in childhood.
- To identify specific risks and sex differences in these sequelae.
Main Methods:
- Analysis of a British national birth cohort (12,537 children) followed to age 23.
- Inclusion of 1667 children with chronic disorders before age 16.
- Assessment of psychological disturbances, Malaise Inventory scores, education, employment, and social activities.
Main Results:
- Men with chronic disorders showed increased risks for psychological distress (Malaise Inventory), needing specialist psychological care, poor educational qualifications, unemployment, and reduced social drinking.
- Women with chronic disorders had a higher risk of consulting mental health specialists.
- Some risks were amplified in specific diagnostic subgroups among men.
Conclusions:
- Chronic physical disorders in childhood are associated with significant long-term psychosocial sequelae, with notable sex differences.
- These findings underscore the importance of addressing psychosocial aspects in the care of children with chronic conditions.
- Clinicians should be vigilant regarding the mental health and social well-being of these individuals.
Objective:
This study was designed to examine the long-term psychosocial sequelae of chronic physical disorders that begin during childhood.
Design:
We analyzed data from a national birth cohort. 12,537 children were followed until age 23 years--76% of all born in Britain during one week in 1958. Of these, 1667 had a chronic disorder before age 16 and 1279 were included in the 23-year follow-up.
Measures:
Outcome measures included self-reported psychological disturbances between ages 16 and 23, scores on the Malaise Inventory, social class, educational qualifications, unemployment, and social activities.
Results:
The total cumulative incidence rate before 16 years was 109.5 per 1000. Demographic comparisons showed that the group with chronic physical disorders was similar to those free of chronic disorders in all respects except the sex ratio. Men with chronic physical disorders had significantly higher relative risks for abnormal scores on the Malaise Inventory (1.52, confidence interval [CI] 1.13, 2.05); specialist psychological care (1.43, CI 1.00, 2.03); poor educational qualifications (1.26, CI 1.08, 1.47); periods of unemployment (1.20, CI 1.03, 1.41); and less social drinking (1.36, CI 1.15, 1.60). In contrast, women only had a significantly elevated risk for having seen a mental health specialist (1.32, CI 1.02, 1.71). Among the men some of the risks were further elevated for those in specific diagnostic groups. These findings are examined in the light of postulates about the impact of chronic physical disorders as a whole and in an attempt to explain the striking sex differences. For clinicians they provide further reason to justify concern about the psychosocial aspects of care for children with chronic disorders.