Mental disorder comorbidity in children and youth with chronic physical illness: A 48-month follow-up

BACKGROUND: Few studies investigate longer-term continuity of mental disorder among children and youth with chronic physical illness. OBJECTIVES: This study examined the prevalence and predictors of homotypic and heterotypic continuity of mental disorder in children and youth with chronic physical illness. METHODS: Children and youth (2-16 years) with physical illness were recruited from outpatient clinics at a pediatric hospital (N = 263) and followed for 48 months. Mental disorder was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents. Generalized estimating equations were computed to identify clinical, parent, and demographic predictors of continuity. RESULTS: Mental disorder was observed in 24 %-38 % (child-report) and 35 %-39 % (parent-report) of children and youth. Prevalence increased from baseline to 48 months for child-reports (p < 0.05). Child-reported models revealed significant homotypic continuity for mood (OR = 5.5 [2.4, 12.9]) and anxiety disorder (OR = 5.4 [2.3, 12.8]), and heterotypic continuity between baseline anxiety and subsequent mood disorder (OR = 6.1 [2.5, 14.5]), and baseline mood and subsequent anxiety disorder (OR = 2.5 [1.1, 5.8]). Parent-reported models revealed significant homotypic continuity for all disorders (ORs = 2.6-7.7), and heterotypic continuity between baseline mood and subsequent anxiety disorder (OR = 2.4 [1.3, 4.7]), baseline anxiety disorder/ADHD and subsequent behavior disorder (OR = 2.7 [1.1, 6.9]/OR = 4.9 [2.0, 11.8]), and baseline behavior and all mental disorders (ORs = 3.5-9.4). Child/youth disability (ORs = 1.2-1.4) and parent psychopathology (ORs = 1.1-1.5) were consistent predictors of continuity. CONCLUSIONS: Mental disorder is prevalent and persistent in children and youth with physical illness. Child/youth disability and parent psychopathology may be priority targets to prevent and screen for physical-mental comorbidity in children and youth.