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

Thomas Jozefiak, Bo Larsson, Lars Wichstrøm, Jan Wallander, Fritz Mattejat, Thomas Jozefiak, Bo Larsson, Lars Wichstrøm, Jan Wallander, Fritz Mattejat

Abstract

Background: During 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.

Methods: No 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.

Results: Both 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.

Conclusions: Child 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.

References

    1. Sawyer MG, Whaites L, Rey JM, Hazell PL, Graetz BW, Baghurst P. Health-related quality of life of children and adolescents with mental health disorders. J Am Acad Child Adolesc Psychiatry. 2002;41(5):530–537. doi: 10.1097/00004583-200205000-00010.
    1. Varni JW, Burwinkle TM. The PedsQL™ 4.0 as a patient-reported outcome in children and adolescents with attention-deficit/hyperactivity disorder:a population-based study. Health Qual Life Outcomes. 2006;4:26. doi: 10.1186/1477-7525-4-26.
    1. Bastiaansen D, Koot HM, Bongers IL, Varni JW, Verhulst FC. Measuring quality of life in children referred for psychiatric problems: Psychometric properties of the PedsQL™ 4.0 generic core scales. Qual of Life Res. 2004;13:489–495. doi: 10.1023/B:QURE.0000018483.01526.ab.
    1. Bastiaansen D, Koot HM, Ferdinand RF, Verhulst FC. Quality of life in children with psychiatric disorders: Self-, parent, and clinician report. J Am Acad Child Adolesc Psychiatry. 2004;43(2):221–230. doi: 10.1097/00004583-200402000-00019.
    1. Bastiaansen D, Koot HM, Ferdinand RF. Determinants of quality of life in children with psychiatric disorders. Qual of Life Res. 2005;14:1599–1612. doi: 10.1007/s11136-004-7711-2.
    1. Bastiaansen D, Koot HM, Ferdinand RF. Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction? Eur Child Adolesc Psychiatry. 2005;14:364–370. doi: 10.1007/s00787-005-0481-8.
    1. Clark DB, Kirisci L. Posttraumatic stress disorder, depression, alcohol use disorders and quality of life in adolescents. Anxiety. 1996;2:226–233. doi: 10.1002/(SICI)1522-7154(1996)2:5<226::AID-ANXI4>;2-K.
    1. Escobar R, Soutullo CA, Hervas A, Gastaminza X, Polavieja P, Gilaberte I. Worse quality of life for children with newly diagnosed attention-deficit/hyperactivity disorder, compared with asthmatic and healthy children. Pediatrics. 2005;116(3):e364–e369. doi: 10.1542/peds.2005-0386.
    1. Graham P, Stevenson J, Flynn D. A measure of health-related quality of life for children: Preliminary findings. Psychol Health. 1997;12:655–665. doi: 10.1080/08870449708407412.
    1. Hakkaart-van Roijen L, Zwirs BWC, Bouwmans C, Tan SS, Schulpen TWJ, Vlasveld L, Buitelaar JK. Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD) Eur Child Adolesc Psychiatry. 2007;16(5):316–326. doi: 10.1007/s00787-007-0603-6.
    1. Klassen AF, Miller A, Fine S. Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit/hyperactivity disorder. Pediatrics. 2004;114:e541–547. doi: 10.1542/peds.2004-0844.
    1. Klassen AF, Miller A, Fine S. Agreement between parent and child report of quality of life in children with attention-deficit/hyperactivity disorder. Child Care Health Dev. 2006;32(4):397–406. doi: 10.1111/j.1365-2214.2006.00609.x.
    1. Landgraf JM, Rich M, Rappaport L. Measuring quality of life in children with attention-deficit/hyperactivity disorder and their families. Development and evaluation of a new tool. Arch Pediatr Adolesc Med. 2002;156:384–391.
    1. Mattejat F, Simon B, König U, Quaschner K, Barchewitz C, Felbel D, Herpetz-Dahlmann B, Höhne D, Janthur B, Jungmann J, Katzenski B, Naumann A, Nölkel P, Schaff C, Schulz E, Warnke A, Wienand F, Remschmidt H. Lebensqualität bei psychisch kranken Kindern und Jugendlichen. (Quality of life of children and adolescents with mental health disorders) Z Kinder-Jugendpsychiatrie. 2003;31(4):293–303. doi: 10.1024/1422-4917.31.4.293.
    1. Matza LS, Rentz AM, Secnik K, Swensen AR, Revicki D, Michelson D, Spencer T, Newcorn JH, Kratochvil CJ. The links between health-related quality of life and clinical symptoms among children with attention-deficit hyperactivity disorder. Dev Behav Pediatr. 2004;25(3):166–174. doi: 10.1097/00004703-200406000-00005.
    1. Riley AW, Spiel G, Coghill D, Döpfner M, Falissard B, Lorenzo MJ, Preuss U, Ralston SJ. Factors related to health-related quality of life (HRQoL) among children with ADHD in Europe at entry into treatment. Eur Child Adolesc. 2006;15(Suppl 1):I/38–I/45.
    1. Schubert MT, Herle M, Wurst E. ICD-10 Diagnostik und Lebensqualität. Pilotstudie zur Lebensqualität psychisch auffälliger Kinder und Jugendlicher. (ICD-10 Diagnosis and quality of life in children and adolescents with mental health problems) Z Kinder-Jugendpsychiatrie. 2003;31(4):285–291. doi: 10.1024/1422-4917.31.4.285.
    1. Varni JW, Limbers C, Burwinkle TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comperative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:43. doi: 10.1186/1477-7525-5-43.
    1. Wurst E, Herle M, Fuiko R, Hajszan M, Katkhouda C, Kieboom A, Schubert MT. Zur Lebensqualität chronisch kranker und psychisch auffälliger Kinder. (Quality of life of children with chronical and mental health disorders.) Z Kinder-Jugendpsychiatrie. 2002;30(1):21–28. doi: 10.1024//1422-4917.30.1.21.
    1. Jozefiak T, Larsson B, Wichstrøm L, Ravens-Sieberer U, Mattejat F. Quality of life as reported by school-aged children and their parents: a cross-sectional survey. Health Qual Life Outcomes. 2008;6:34. doi: 10.1186/1477-7525-6-34.
    1. Ravens-Sieberer U, Bettge S, Erhart M. Lebensqualität von Kindern und Jugendlichen - Ergebnisse des Kinder- und Jugendgesundheitssurveys. (Quality of life in children and adolescents - Results from the child and adolescent surveys) Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz. 2003;46:340–345. doi: 10.1007/s00103-002-0562-5.
    1. Kaestner F. PhD thesis. Philipps-University Marburg, Germany, Faculty of Medicine; 2000. Messung der Lebensqualität von Kindern und Jugendlichen. (Measuring Quality of Life in Children and Adolescents)
    1. Le Coq EM, Boeke AJP, Bezemer PD, Colland VT, van Eijk JTM. Which source should we use to measure quality of life in children with asthma:The children themselves or their parents? Qual Life Res. 2000;9(6):625–636. doi: 10.1023/A:1008977200176.
    1. Spieth LE. In: Quality of Life in Child and Adolescent Illness. 1. Koot HM, Wallander JL, editor. New York: Brunner-Routledge; 2001. Generic health related quality of life measures for children and adolescent; pp. 49–88.
    1. Davis E, Nicolas C, Waters E, Cook K, Gibbs L, Gosch A, Ravens-Sieberer U. Parent- proxy and child self-reported health-related quality of life: using qualitative methods to explain the discordance. Qual Life Res. 2007;16:863–871. doi: 10.1007/s11136-007-9187-3.
    1. Jozefiak T, Larsson B, Wichstrøm L. Changes in Quality of Life among Norwegian school children: a six-month follow-up study. Health Qual Life Outcomes. 2009;7:7. doi: 10.1186/1477-7525-7-7.
    1. Jozefiak T. PhD thesis. Norwegian University of Science and Technology, Trondheim, Norway, Faculty of Medicine; 2009. Quality of life and mental health in children and adolescents: Child and parent perspectives.
    1. Davis E, Davies B, Waters E, Priest N. The relationship between proxy reported health-related quality of life and parental distress: gender differences. Child Care Health Dev. 2008;34(6):830–7.
    1. Eiser C, Morse R. Can parents rate their child's health-related quality of life? Results of a systematic review. Qual Life Res. 2001;10(4):347–257. doi: 10.1023/A:1012253723272.
    1. Eiser C, Morse R. The Measurement of quality of life in children: Past and future perspectives. J Dev Behav Pediatry. 2001;22(4):248–256.
    1. Koot HM. In: Quality of Life in Child and Adolescent Illness. 1. Koot HM, Wallander JL, editor. New York: Brunner-Routledge; 2001. The study of quality of life: Concepts and methods; pp. 3–20.
    1. Mattejat F, Remschmidt H. Zur Erfassung der Lebensqualität bei psychisch gestörten Kindern und Jugendlichen - Eine Übersicht. (Assessment of life quality in children and adolescents with mental disorders - An overview) Z Kinder-Jugendpsychiatrie. 1998;26:183–196.
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4. Washington, DC; 2000. text revision.
    1. Achenbach TM, Rescorla L. An Integrated System of Multi-informant Assessment - School-Age Forms and Profiles. 1. USA: Library of Congress; 2001.
    1. Angold A, Messer SC, Stangl D, Farmer EMZ, Costello EJ, Burns BJ. Perceived parental burden and service use for child and adolescent psychiatric Disorders. Am J Public Health. 1998;88(1):75–80. doi: 10.2105/AJPH.88.1.75.
    1. Reigstad B, Jørgensen K, Sund AM, Wichstrøm L. Adolescents referred to specialty mental health care from local services and adolescents who remain in local treatment: what differs? Soc psychiatry psychiatric epidemiol. 2006;41:323–331. doi: 10.1007/s00127-005-0027-x.
    1. Angold, The Child and Adolescent Psychiatric Assessment Interview (CAPA). Chapter: Attitudes and barriers to services.
    1. Steinsbekk S, Jozefiak T, Ødegård R, Wichstrøm L. Impaired parent-reported quality of life in treatment-seeking children with obesity is mediated by high levels of psychopathology. Qual Life Res. 2009;18(9):1159–67. doi: 10.1007/s11136-009-9535-6.
    1. Mattejat F, Remschmidt H. Das Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen (ILK). (The Inventory of Life Quality in Children and Adolescents ILC) 1. Bern: Hans Huber Verlag; 2006.
    1. Ravens-Sieberer U, Bullinger M. Manual for the KINDL-R Questionnaire for measuring health-related Quality of Life in children and adolescents - Revised Version. 2000.
    1. Nøvik TS. Validity of the Child Behaviour Checklist in a Norwegian sample. Eur Child Adolesc Psychiatry. 1999;8:247–254. doi: 10.1007/s007870050098.
    1. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Geneva; 1993.
    1. Sourander A, Niemela S, Santalathi P, Helenius H, Piha J. Changes in psychiatric problems and service use among 8-year-old children: A 16-year population-based time-trend study. J Am Acad Child Adolesc Psychiatry. 2008;47(3):317–327. doi: 10.1097/CHI.0b013e318160b98f.

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