Quality of Life as reported by children and parents: a comparison between students and child psychiatric outpatients

Abstract

BackgroundDuring the recent decade, a number of studies have begun to address Quality of Life (QoL) in children and adolescents with mental health problems in general population and clinical samples. Only about half of the studies utilized both self and parent proxy report of child QoL. Generally children with mental health problems have reported lower QoL compared to healthy children. The question whether QoL assessment by both self and parent proxy report can identify psychiatric health services needs not detected by an established instrument for assessing mental health problems, i.e. the Child Behavior Checklist (CBCL), has never been examined and was the purpose of the present study.MethodsNo study exists that compares child QoL as rated by both child and parent, in a sample of referred child psychiatric outpatients with a representative sample of students attending public school in the same catchment area while controlling for mental health problems in the child. In the current study patients and students, aged 8-15.5 years, were matched with respect to age, gender and levels of the CBCL Total Problems scores. QoL was assessed by the self- and parent proxy-reports on the Inventory of Life Quality in Children and Adolescents (ILC). QoL scores were analyzed by non-parametric tests, using Wilcoxon paired rank comparisons.ResultsBoth outpatients and their parents reported significantly lower child QoL on the ILC than did students and their parents, when children were matched on sex and age. Given equal levels of emotional and behavioural problems, as reported by the parents on the CBCL, in the two contrasting samples, the outpatients and their parents still reported lower QoL levels than did the students and their parents.ConclusionsChild QoL reported both by child and parent was reduced in outpatients compared to students with equal levels of mental health problems as reported by their parents on the CBCL. This suggests that it should be helpful to add assessment of QoL to achieve a fuller picture of children presenting to mental health services.

Quality of life in children and adolescents surviving cancer

“…In this study our results are in accordance with other studies reporting a discrepancy between the self-report and proxy report in different clinical and general population studies (Theunissen et al, 1998;Chang and Yeh, 2005;Yeh and Chang, 2005;Jozefiak et al, 2008Jozefiak et al, , 2009Jozefiak et al, , 2010. However, our study also showed that comparing QoL child vs. proxy report directly in studies of children surviving cancer could be misleading without including a control group.…”

“…The ILC was translated into Norwegian according to international standards and approved by the original authors. The Norwegian version of the ILC for adolescents (aged 12e18 years and may be used up to 20 years) and their parents have shown satisfactory reliability (Jozefiak et al, 2008(Jozefiak et al, , 2010. Both adolescent (self-report) and parent (proxy report for children and adolescents from 4 to 20 years) versions were used in the present study.…”

Quality of life in children with OCD before and after treatment

“…That only parents reported reduced QoL in children with comorbid conditions might be due to the general tendency of children to rate their QoL with a more optimistic view than their parents, as seen in other studies. In studies of parent-child agreement on QoL, parents of children in non-clinical samples tend to report higher QoL scores than their children (Jozefiak et al, 2010;, while parents of children with disorders tend to under-estimate QoL compared with their children. In Lack and coworkers' (2009) study, parents generally rated QoL lower than their children did, suggesting that young people may minimize the impact of their condition on QoL.…”

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

“…This may lead to biased results, because it is possible that children who have both a mental disorder and reduced HRQOL are more likely to be referred to or treated in a clinic, compared to children with mental disorders without a marked reduction in HRQOL [25]. For example, in a recently published study, referred psychiatric outpatients exhibited lower HRQOL scores than students with equivalent levels of emotional and behavioral problems [52]. Hence, studies that use population-based approaches should be considered to validate the results found among clinical samples.…”