Health-related quality of life among children with mental disorders: a systematic review

Abstract

PURPOSE: To systematically review studies about the quality of life (QOL) of children with various mental disorders relative to healthy controls and to describe limitations in these studies. METH-ODS: Relevant articles were searched using different databases, by checking reference lists and contacting experts. We included articles that either compared children with mental disorders to healthy controls/norm values or made such a comparison possible. RESULTS: Sixteen out of 4,560 articles met the pre-defined inclusion criteria. These studies revealed that the QOL of children with various mental disorders is compromised across multiple domains. The largest effect sizes were found for psychosocial and family-related domains and for the total QOL score, whereas physical domains generally were less affected. The most important limitations in the existing literature include the lack of study samples drawn from the general population, the failure to use self-ratings, not considering item overlap between measuring QOL and assessing for the presence of a particular mental disorder, and not determining whether the children were receiving medication for their mental disorder. CONCLUSIONS: Children with mental disorders experience a considerable reduction in QOL across various domains. Research studies that avoid previous limitations are crucial to fill existing knowledge gaps. Results: Sixteen out of 4,560 articles met the pre-defined inclusion criteria. These studies revealed that the QOL of children with various mental disorders is compromised across multiple domains. The largest effect sizes were found for psychosocial and family-related domains and for the total QOL score, whereas physical domains generally were less affected.The most important limitations in the existing literature include the lack of study samples drawn from the general population, the failure to use self-ratings, not considering item overlap between measuring QOL and assessing for the presence of a particular mental disorder, and not determining whether the children were receiving medication for their mental disorder. Conclusions:Children with mental disorders experience a considerable reduction in QOL across various domains. Research studies that avoid previous limitations are crucial to fill existing knowledge gaps.

Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy

“…The fact that mental health was worse among parents of children with mental relative to physical health problems (results not shown) might have also been a contributing factor, since caregivers with worse mental health were more likely to perceive their child's problem as more severe. The finding that mental health problems were relatively more severe is also in line with the large burden of disease [7,8] as well as the compromised quality of life associated with such conditions [9]. Furthermore, stigma and self-blame associated with mental disorders [10][11][12][13] may lead parents to seek help only when the situation becomes severe.…”

“…Mental health problems are, among other conditions, prevalent in this age group due to the early onset of many disorders [3][4][5][6][7]. Such problems also account for a large proportion of the disease burden in young people [7,8], compromise various quality of life domains [9] and exert an additional impact upon parents (e.g., experiencing stigma or self-blame) [10][11][12][13].…”

Exploring the relationship between quality of life and mental health problems in children: implications for measurement and practice

“…Second, as noted by Dey et al [1] there is a need for research on quality of life and mental health to take into account the fact that there is considerable conceptual and measurement overlap between these constructs. A strength of this study is that we have conducted sensitivity analyses to help to untangle the role of item overlap on the findings.…”

“…Second, greater attention needs to be paid to child reports of quality of life in both clinical and general population groups, as many studies rely on parents' perceptions of their child's quality of life [1]. Given that quality of life is fundamentally a subjective phenomenon, relying on proxy reports from others is problematic.…”

“…A third challenge has been untangling whether the observed associations between mental health and quality of life are simply a reflection of item overlap [1], i.e. relying on similar questions to measure common components of mental health and quality of life (e.g.…”