PEDIATRICS Vol. 89 No. 3 March 1992, pp. 445-449
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Chronic Illness and Mental Health Problems in Pediatric Practice: Results From a Survey of Primary Care Providers

Stephan K. Weiland MD, MSc1, Ivan B. Pless MD, FRCP2, and Klaus J. Roghmann PhD3

1 From Ruhr University Bochum, Abteilung für Sozialmedizin und Epidemiologie, Germany
2 From McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada
3 From University of Rochester, School of Medicine, Rochester, NY.

The prevalence of chronic physical illnesses and their association with mental disorders was assessed using data collected by primary care pediatricians. A chronic illness was diagnosed in 1573 (15.6%) of 10 058 children aged 4 to 16 years, 945 (9.4%) of whom had a "serious" disorder, 535 (5.3%) had a minor disorder (hay fever or dermatitis), and 121 (1.2%) had a speech or language disorder. Behavioral problems were identified more often among patients with "serious" disorders than among those without chronic illnesses (2.4% vs 1.7%), as were emotional problems (5.0% vs 3.1%). Among those with "serious" conditions involving the central nervous system, the prevalence of behavioral (5.2%) and emotional (10.4%) disorders was still higher. Although children with "serious" disorders not involving the central nervous system also showed elevated prevalence rates of behavioral (2.1%) and emotional (4.5%) disturbances, this increase did not reach statistical significance. No association with "minor" chronic disorders was found. The negative impact of these mental health problems on the child was more severe when a chronic illness was also present, but referrals for mental health services did not reflect his association.

Key Words: chronic illness • mental health • primary care

Submitted on August 21, 1990
Accepted on March 11, 1991




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