ARTICLES
Health-Related Quality of Life of Children and Adolescents With Mental Disorders

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ABSTRACT

Objective

To compare the health-related quality of life (HRQL) between children aged 6–17 years with one of three mental disorders (attention-deficit/hyperactivity disorder, major depressive disorder, or conduct disorder), a physical disorder, and those with none of these disorders.

Method

Parent reports describing the HRQL, mental disorders, and physical disorders of a national sample of 3,597 children and adolescents in Australia, aged 6–17 years (response rate = 70%), were obtained by means of a structured diagnostic interview and questionnaires.

Results

After controlling for age, gender, and family structure, children with mental disorders were reported to have a significantly worse HRQL in several domains than children with no disorder. In many areas they were reported to have a worse HRQL than children with physical disorders. Parents also reported that the problems of children with mental disorders interfered significantly with the daily lives of children, parents, and families.

Conclusions

The findings are consistent with previous studies which have reported that adults with mental disorders have substantial impairment in their HRQL. The findings suggest that children with a mental disorder require help in many areas of their lives. Achieving this will require an integrated approach to health care delivery rather than the current distinction between physical and mental health services.

Section snippets

Participants

The participants were 3,597 children aged 6 to 17 years recruited for the Child and Adolescent Component of the National Survey of Mental Health and Wellbeing in Australia (Sawyer et al., 2000). Parents or primary caregivers completed the parent version of the Diagnostic Interview Schedule for Children Version IV (DISC-IV) modules used to identify major depressive disorder (MDD), conduct disorder (CD), and attention-deficit/hyperactivity disorder (ADHD). The 1-year prevalence of MDD was 2.4% (n

HRQL of Children With Mental Disorders Versus No Mental Disorder

The mean CHQ scores reported by caregivers are shown in Table 2. The left-hand column displays the mean scores for children in the no-disorder group, and the remaining three columns show the mean differences between scores reported for children in this group and those with MDD, CD, or ADHD.

The physical and mental health of children with mental disorders was consistently rated as worse than that of children in the no-disorder group. It is not surprising that parents of children with mental

DISCUSSION

Parents’ perceptions of children's HRQL correlated with the presence or absence of one of the three mental disorders. Parents of children with MDD, CD, or ADHD perceived that the health problems of these children interfered with their peer relationships and with the daily lives of parents and families. In some areas the level of interference was perceived as being greater than that which was reported by the parents of children with physical health problems. This is a significant finding if it

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    This work was funded by the Commonwealth Department of Health and Aged Care and supported by a national collaborating group of researchers in Australia.

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    Copyright © 2002 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.