Predictors of delayed social maturation and mental health disorders in young adults chronically ill since childhood

Abstract

To ascertain the influence of juvenile-onset chronic physical diseases and associating factors of social environment on delayed social maturation and mental health disorders in young adults, we analysed a group of 407 (184 female, 223 male) subjects with these conditions and compared the results with those of 123 (63 female, 60 male) healthy controls studied at the age of 19-25 years. The social maturation index was formed on the basis of a demographic interview, which also reviewed the state of social development and the family situation during childhood. Mental health disorders were assessed with a Present State Examination (PSE) interview analysed with the CATEGO program. With regard to social maturation at least half of the patients and controls were doing well, whereas for 29% (CI(95), 25%-33%) of the patients and 17% (CI(95), 10%-24%) of the controls the index showed delayed maturation. Subjects with poor social maturation were found most often among the disabled patients but also among the patients without severe diseases. The prevalence of PSE-CATEGO-identified psychiatric syndromes was equal in the patients and the controls (22% versus 20%). However, the patients with severe or disabling diseases had more severe psychiatric syndromes. The prevalences of depressive syndromes were also equal, but the depression of the patients was more often a profound affective disorder. Male sex, poor scholastic and vocational success, and social problems in the family during childhood were significantly associated with poor social maturation. On the other hand, the most significant predictors of mental health problems in young adults were female sex, family distress during childhood, and a severe disease. Juvenile-onset physical disease was considered to delay social maturation in some subjects and to deepen or modulate the clinical picture of mental health disorders. It is concluded that juvenile-onset physical diseases combined with family-related factors affect in different ways the social growth and psychiatric well-being. The results suggest that the subjects with chronic diseases during childhood should be thoroughly assessed by a child psychiatrist to evaluate the orientation of psychological development and the impact of the child's disease on the family and to ensure balanced psychological and social growth.

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“…Routine HRQOL assessment can facilitate detection and discussion of psychosocial issues related to chronic health conditions. Moreover, it can provide a chance to refer patients with significant risks of an unfavorable psychosocial outcome for interventions and to help these patients to achieve optimal development [20,21]. …”

Impacts of HIV Stigma on Psychosocial Well-Being and Substance Use Behaviors Among People Living With HIV/AIDS In China: Across the Life Span

“…Younger people are usually more sensitive to prejudice attitudes from their peers and other people with less well-adaptive coping strategies (Chittleborough et al, 2011; Geist, Grdisa, & Otley, 2003; Kokkonen, Kokkonen, & Moilanen, 2001). In addition to dealing with their infection, young PLWHA may also need to cope with stressors from physical changes, financial balance, and self-identity (Chittleborough et al, 2011; Geist et al, 2003; Kokkonen et al, 2001). Middle-aged people might bear the responsibility of taking care of their families/parents, and endure job-related pressures, which is particularly evident in Chinese settings.…”