Background and Aims
Evidence suggests that physical and mental illness are strongly correlated in children. This study examined factors associated with the chronicity of multimorbidity (co-occurring physical and mental illness) in children newly diagnosed with a chronic physical illness.
Children aged 6-16 years diagnosed with one of asthma, diabetes, epilepsy, food allergy, or juvenile arthritis were recruited from two children’s hospitals and followed for six months. Child mental illness was measured using the parent-reported Mini International Neuropsychiatric Interview and Ontario Child Health Study Emotional Behavioural Scales at baseline and six months later. Children were stratified into three groups: no multimorbidity, acute (multimorbidity at only one assessment), and persistent (multimorbidity at both assessments). Multinomial logistic regression was used identify factors associated with the chronicity of multimorbidity.
Forty-nine children were available for analysis: no multimorbidity (n=18), acute (n=13), and persistent (n=18). No associations were found between sociodemographic factors and chronicity; however, unadjusted analyses showed positive associations between child and parent behavioural symptoms, as well as family functioning with persistent multimorbidity. These associations remained after adjustment, ranging from OR=1.27 (1.01, 1.62) for depression to OR=1.61 (1.11, 2.33) and OR=1.61 (1.10, 2.35) for attention-deficit hyperactivity and oppositional defiant, respectively in child models. In parent models, associations remained for parental anxiety [OR=1.19 (1.04, 1.36)] and stress [OR=1.14 (1.01, 1.29)].
Multimorbidity is persistent in children newly diagnosed with physical illnesses, regardless of the behavioural symptoms experienced. Integrating mental health services soon after the diagnosis of a physical illness should be prioritized in pediatric settings.