• Child Psychiatry
• Child Psychology
• Evidence Based Medicine
• Psychology

Chronic illness significantly increases the risk of psychiatric disorder in children and young people. Bennet et al1 report a systematic review of psychological interventions for mental health problems in children with chronic physical illness. They found only 10 studies meeting their criteria, only two of which were randomised controlled trials. This is despite the fact that large-scale epidemiological studies have consistently shown that chronic illness is common in childhood and that children with chronic illness are more likely to have psychiatric disorders.2 ,3 Chronic illness appears to be a generic risk factor rather than being associated with particular psychiatric diagnoses, although certain types of chronic illness, notably those involving the central nervous system, are associated with higher levels of psychiatric disorder.

The personal burden on children and their families, and the economic burden on health, education, social care and youth justice services in dealing with these long-term conditions are immense. A significant part of this burden relates to the higher rates of mental health disorder in children with chronic illness described above. Moreover, the sequelae of mental health disorders can exacerbate long-term physical health conditions, which in turn can exacerbate the mental health disorder setting up vicious cycles of worsening morbidity. Mechanisms are likely to …