Wednesday, June 19, 2019

Chronic Physical Conditions in Youth May Raise Risk for Mental Health Conditions

Young people with chronic physical conditions such as asthma or diabetes are more likely to be at risk for later mental health conditions, according to a report released this month in Pediatrics.

Moreover, the limitations that young people may experience because of their chronic physical conditions appear to contribute to their risk for mental health problems, said John Adams, M.D., and colleagues in the Department of Pediatrics at the Cambridge Health Alliance.

“[P]rograms and policies designed to improve care of youth with chronic physical conditions should identify opportunities to … modify the physical or social environment" so young people can “fully participate in activities important to their developmental progress,” they wrote.

Adams and colleagues analyzed data from the Medical Expenditure Panel Survey (MEPS) from 2003 to 2014 on 48,572 youth aged 6 to 25 years. MEPS, a nationally representative survey of the U.S. population conducted by the Agency for Healthcare Research and Quality, asks respondents open-ended questions about health problems and medical encounters that occurred during the reporting period.

MEPS also asks participants if they are limited in their ability to “work at a job, do housework, or go to school” or “participate in social, recreational, or family activities” because of an “impairment or a physical or mental health problem.”

The researchers calculated the two-year cumulative incidence of mental health conditions overall according to whether individuals had a chronic physical condition at baseline. They also looked at whether young people limited their activities due to the physical condition.

Among youth with a physical condition at baseline, 11.5% developed a mental health condition in the next two years compared with 7.1% of youth without a chronic physical condition at baseline. Moreover, youth with baseline physical conditions were three times more likely to report activity limitations, and these youth had a 3.6-times greater risk of a mental health condition.

They calculated that limitations on activity explained 13.5% of the relationship between current physical conditions and subsequent mental health conditions, the researchers stated.

“[S]uch limitations could reduce opportunities for protective exposures or lead to specific harms to mental health such as through decreased educational achievement, increased social stigma, or diminished social well-being,” the researchers said. And these effects may be especially important during adolescence and early adulthood “when gaining autonomy, forming identity, and developing positive relationships are predominant developmental tasks.”

For related information see the Psychiatric News article “Teens With Depression Benefit From Collaborative Care Model.”

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