Health-related quality of life of children and adolescents with mental disorders
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RESEARCH
Open Access
Health-related quality of life of children and adolescents with mental disorders Katharina Weitkamp1*, Judith K Daniels2, Georg Romer3 and Silke Wiegand-Grefe1
Abstract Background: The aim was to assess the association of internalising and externalising pathology with the child’s health-related quality of life (QoL), and to determine which child and environmental characteristics beyond pathology were related to poor QoL. Methods: Data was obtained for 120 children and adolescents (aged 6 to 18) commencing outpatient psychotherapy treatment. Parents and children (aged 11 years and older) filled out questionnaires. QoL was measured with the KIDSCREEN-27. Results: QoL was more strongly associated with internalising than externalising pathology according to both selfand parent report. Multiple regression analyses showed that beyond internalising and externalising pathology, gender, age, family functioning, functional impairment, and prior mental health treatment were associated with individual QoL scales. Conclusions: The data underscored the relationship between mental pathology and impaired QoL even if potential item overlap was controlled for. This stresses the importance of extending therapy goals and outcome measures from mere pathology to measures of QoL in psychotherapy research particularly for patients with internalising pathology. Keywords: Quality of life, Internalising disorders, Externalising disorders, Child, Adolescent
Introduction Research on health-related quality of life (QoL) in children and adolescents with psychiatric disorders is still in its early stages. Though in evidence-based assessment it has been suggested to supplement the measure of pathology with the assessment of QoL and functioning in child psychotherapy research [1]. This seems warranted, since suffering from a psychiatric disorder during childhood and adolescence has a considerable impact on the child’s subjective satisfaction with his or her day-to-day activities and social well-being [2,3]. QoL in children with mental health problems is not only considerably poorer than in healthy children, but QoL seems to be more severely impaired even when compared with children suffering from a chronic somatic illness [4,5].
* Correspondence: [email protected] 1 Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany Full list of author information is available at the end of the article
It seems critical to search for influencing factors beyond the specific association with pathology so that therapists might respond in a more targeted way. In a first study on factors influencing QoL in children with a psychiatric disorder, Bastiaansen and his colleagues [6] noted that the impact of psychopathology was larger in girls than in boys, possibly because children with externalising behaviour problems (predominantly males) may not experience their symptoms as problematic. Secondly, the impact of psychopathology increased with age. However,
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