Chronic illness and its consequences:Observations based on three epidemiologic surveys

doi:10.1016/S0022-3476(71)80141-5

The Journal of Pediatrics

Volume 79, Issue 3, September 1971, Pages 351-359

https://doi.org/10.1016/S0022-3476(71)80141-5 Get rights and content

The findings of three epidemiologic surveys relating to the psychological and social consequences of chronic physical disorders are presented. The prevalence of the categories of disorder considered and the over-all prevalence of them are estimated. Comparisons of the chronically ill with healthy control subjects in two of the studies permit the conclusion that the only demographic characteristic distinguishing the groups is the higher ratio of boys among the chronically ill. The children with chronic physical disorders are subdivided by type, duration, and severity of illness, and these characteristics are related to the frequency of secondary handicaps in the areas of educational achievement, behavior, and psychologic maladjustment. In each of these areas the chronically ill fare significantly less well. The need for more effective comprehensive services to prevent secondary handicaps is highlighted by these findings.

References (12)

ChamberlinRobert W.
Social data in evaluation of the pediatric patient: Deficits in outpatient records
J. Pediat.
(1971)
IllingworthR.S.
The increasing challenge of handicapped children
Clin. Pediat.
(1964)
DouglasJ.W.B. et al.
Children under five
(1958)
DouglasJ.W.B.
The home and the school
(1964)
RutterM. et al.
Education, health and behavior
(1970)
RoghmannK.J. et al.
Rochester Child Health Surveys. I. Objectives organization and methods
Medical Care
(1970)

There are more references available in the full text version of this article.

Cited by (214)

Traumatic stress, mental health, and quality of life in adolescents with esophageal atresia
2022, Journal of Pediatric Surgery
Citation Excerpt :
Dysphagia, gastro-esophageal reflux (GER), tracheomalacia and esophageal stenosis represent long-term problems reported in EA patients, often requiring long-lasting hospitalizations with repeated invasive diagnostic and treatment procedures throughout childhood [3]. Although prior studies have demonstrated that children with neonatal surgical malformations may experience negative effects on neurodevelopment and psychological development with long-term risk of developing mental health and psychosocial problems [4-10], it is still unclear how neonatal treatment and long-term morbidities impact behavior and emotional health [4, 11-15]. Studying one year old infants with EA, Faugli et al. diagnosed mental health disorder in 31% of the infants [16].
We aimed to investigate QoL in EA patients in relation to comparison groups and to clinical factors including experienced traumatic stress.
Adolescents with EA in Norway born between 1996 and 2002 were included. Clinical assessment and patient's characteristics were collected. Quality of life (PedsQL), traumatic stress (IES-13) and mental health (SDQ-20) were compared to groups of healthy controls, children with acute lymphoblastic leukemia (ALL) and kidney transplanted children (TX).
68 EA adolescents participated. Total scores for PedsQL were not different from the healthy group and ALL patients, but significantly better than the TX patients. The subscale for physical performance was significantly lower than in healthy adolescents, and nine (17%) patients had scores ≤70 indicating reduced health status. Five EA adolescents (12%) had mental health scores suggesting a psychiatric disorder, and six (9%) reported high traumatic stress scores with a significant correlation to days on ventilator in the neonatal period. The strongest predictors for quality of life among EA adolescents were self-reported mental health, posttraumatic stress and GERD symptoms.
Scores for Quality of life in the EA group are good except for subscale for physical performance. Symptoms of posttraumatic stress, mental strain and gastroesophageal reflux are predictors of reduced QoL.
A study of educational underachievement in Indian children with epilepsy
2012, Brain and Development
Citation Excerpt :
Children and adolescent with chronic health conditions have substantial risk for excess psychosocial morbidity as evidenced by various clinic based and population based study [1,2].
Background: Epilepsy is a chronic disorder that significantly affects learning and behavior. Children with epilepsy are much more vulnerable for educational problems than with any other chronic illness. Objectives: The study was conducted to assess the extent of educational problems and factors associated with educational underachievement in Indian children with epilepsy. Methods: It was a case control study and included 100 cases of 6–16 years age of epilepsy, 50 healthy children (control A) and 50 children with persistent asthma (control B). Their demographic and disease variables were evaluated. The educational performance was assessed by using a predesigned semi structured open ended questionnaire to parents and by teacher’s report. Psychological evaluation was done in first step by using a standard questionnaire, childhood psychopathology measurement schedule. In second step, those have shown poor educational performance or significant score in standard questionnaire underwent detailed psychiatric evaluation. Results: Educational problems were reported in cases (36%), control A (2%) and control B (16%). Demographic or disease variables were not associated with educational problems in cases except that boys were more affected than girls. On psychiatric evaluation psychopathological illnesses (47%) like attention deficit hyperkinetic disorder, conduct disorder and depression were found to be commonly associated with poor educational performance (47%) followed by decreased learning opportunities (22.2%) and borderline intelligence (19.4%) in children with epilepsy. Conclusion: Educational problems are commoner in children with epilepsy than with asthma. Psychopathological problems are commonly associated with educational underachievement in children with epilepsy. Therefore periodic psychosocial assessment, counseling and support must be provided to improve the psychosocial adjustment in children with epilepsy.
Psychiatric morbidity in mothers of children attending primary care facility in Ilorin, Nigeria: Drawing attention to those affected concurrently with their children
2011, General Hospital Psychiatry
Citation Excerpt :
The typical dyad consisted of mothers in large polygamous families with poor spousal relationship and support for their children's care and had children who were distressed by chronic illness, lacked education or performed poorly at school. These are factors already mentioned as risks factor for psychosocial dysfunctions in families [14,15,33] and only corroborated by our study. The important point in concurrent morbidity is that the size of burden on the family is increased; coping resources are over-tasked escalating the risk of maladjustment and psychological disorder.
To determine the prevalence of psychiatric morbidity among mothers of children attending a primary care clinic in University of Ilorin Teaching Hospital as precursor to developing an intervention programme.
WThree hundred fifty mothers of children aged 7–14 years were screened with the 12-item General Health Questionnaire for psychiatric morbidity. As part of the larger study, their children were screened for psychiatric disorders with the parents’ version of the Child Behaviour Questionnaire, and a subsample of 157 mother/child dyad had second-stage interview with the children’s version of the Schedule for Affective Disorders and Schizophrenia to determine psychiatric morbidity in these children.
Twenty-eight out of 350 mothers (8%) had probable psychiatric morbidity. Mothers with psychiatric morbidity were significantly more likely to have children with Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition psychiatric diagnosis (8 of 28, P=0.011), experience parenting difficulties with some of their children (13 of 28, P=0.000) and have poor husband support for the care of their children.
The presence of psychiatric morbidity in mothers may require that other members of the family especially the children be screened for psychiatric disorders particularly when there are parenting difficulties and poor spousal support; in this way primary prevention or control can effectively be carried out.
Pediatric Pacing and Defibrillator Use
2011, Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy
Mental health and psychosocial functioning in adolescents with esophageal atresia
2009, Journal of Pediatric Surgery
We examined mental health and psychosocial functioning in adolescents with esophageal atresia (EA) and searched for predictors of impaired outcome.
The study group comprised 21 adolescents with EA and 1 or both parents. A comparison group comprised 36 adolescents from the general population. Mental health, self-esteem, psychosocial functioning, and parental/family functioning were assessed by standardized questionnaires and semistructured interviews. Physical health was assessed by growth and clinical symptoms.
Mental health and psychosocial functioning did not differ from the comparison group. Seven of 21 EA adolescents had special education. Dilatations of esophagus, birth weight, well-being, and maternal psychological distress were prognostic factors predicting mental health. Height, birth weight, well-being, dissociative symptoms, and family strain were prognostic factors predicting psychosocial functioning.
Adolescents with EA adjusted well, and mental health and psychosocial functioning did not differ from controls. Dilatations of esophagus and birth weight were significant predictors of mental health and psychosocial functioning.
Atypical maternal interaction is associated with elevated levels of hair cortisol in children
2023, Frontiers in Pediatrics

View all citing articles on Scopus

^†

Supported in part by funds from Children's Bureau Grant No. H-148 and by Public Health Service Grants HS-47255-01 and CH-00433-02.

Paper presented to the maternal and ChildHealth Section, American Public, Health Association Annual Meeting, Houston, Texas, October, 1970.

^*: Milbank Faculty Fellow, 1968 to 1973.

View full text

Special articleChronic illness and its consequences:Observations based on three epidemiologic surveys†

J. Pediat.

The increasing challenge of handicapped children

Clin. Pediat.

Children under five

The home and the school

Education, health and behavior

Rochester Child Health Surveys. I. Objectives organization and methods

Medical Care

Special article
Chronic illness and its consequences:Observations based on three epidemiologic surveys†