Onset of Psychopathology Among Children With Chronic Physical Illness

BACKGROUND: Children with chronic physical illness (CPI) are highly vulnerable to developing a co-occurring psychopathology, which is associated with compounding negative health effects throughout the life-course. Literature regarding psychopathology onset among children with CPI is sparse; studies are predominantly cross-sectional and illness-specific. This research examined the onset and correlates of internalising and externalising psychopathologies among children with CPI over 48 months. METHODS: Data come from a longitudinal study of 263 children with CPI, aged 2-16 years, and their parent. Child psychopathology was measured using the parent-reported Mini International Neuropsychiatric Interview for Children and Adolescents, which defined the events, internalising and externalising psychopathology onset. Kaplan-Meier survival analyses illustrated internalising and externalising psychopathology onset, and Cox regressions modelled predictors of onset. RESULTS: Overall, 64.1% of children met criteria for an internalising or externalising psychopathology at baseline and throughout follow-up. Average time-to-onset of internalising and externalising psychopathology was approximately 20.4 and 18.1 months, respectively. Children with greater disability (HR = 1.15, 1.00-1.31), were older (HR = 1.15, 1.05-1.27), and had younger parents (HR = 0.91, 0.85-0.97) were most susceptible to an internalising psychopathology. Male children (HR = 0.37, 0.20-0.70), and children exposed to greater parent psychopathology (HR = 1.29, 1.11-1.47) were most likely to develop an externalising psychopathology. CONCLUSIONS: Many children with CPI developed psychopathology, and subgroups of children were identified as most at risk of internalising and externalising psychopathology. Findings support routine mental health screening of children with CPI to foster mental well-being among these vulnerable children.