Longitudinal Relationships Between Depression and Chronic Illness in Adolescents: An Integrative Review

Abstract

Introduction: Depression is prevalent among adolescents with chronic illness. However, little is known about how depression affects chronic illness over time. This review aimed to synthesize longitudinal relationships between depression and disease control, self-management behaviors, illness-related morbidity, and quality of life. Method: Four databases were searched, including PubMed, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and EMBASE. Inclusion criteria were cohort studies examining depression among adolescents aged 10−21 years with a chronic illness and studies published in English. Study quality was appraised using the Newcastle-Ottawa scale and data was synthesized by the outcome. Results: Of the 3,463 articles identified, 11 were included in the review. For adolescents with diabetes, increased depressive symptoms predicted decreased metabolic control and monitoring, medication adherence, quality of life, and increased hospitalization. Studies on cystic fibrosis, congenital heart disease, sickle cell disease, and juvenile idiopathic arthritis were limited but demonstrated that depressive symptoms affected the quality of life, disability, pain, and hospitalization rates/costs. Discussion: Evidence supports the need for mental health care strategies suitable for adolescents with chronic illness. Future research is needed to examine the effects of depressive symptoms across diversified chronic illness populations.

<p>Young Minds: Mental Health and Transitional Care in Adolescent and Young Adult Rheumatology</p>

“…The evidence in the diabetes literature was stronger and increased depressive symptoms in adolescents with diabetes predicted decreased metabolic control and monitoring, medication adherence and increased hospitalizations as well as quality of life. 85 Such evidence further supports the need for routine mental health assessment in rheumatology practice including when assessing adherence to medication, therapy and attendance at appointments, etc.…”

Mental Health Assessment of Youth with Sickle Cell Disease and Their Primary Caregivers During the COVID-19 Pandemic

“…21 Established associations exist between depression and medication non-adherence in chronic illnesses of youth and adults, including adolescents living with SCD. [22][23][24] Hence, the finding of frequent depression at trial enrollment was not surprising. Interestingly, fewer youth reported mental health symptoms in the pandemic survey.…”

Advances in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: A Practical Approach to Transition Program Design: A Scientific Statement From the American Heart Association

“… 25 , 26 , 27 Longitudinal assessments of anxiety and depression throughout transition are important because anxiety and depression represent potential barriers to self‐management as depressed or anxious patients may be reluctant to take responsibility for their health care decision making. 28 , 29 Information about how and when to access mental health support should be included as part of a transition education curriculum. 30 …”