Late Consequences of Chronic Pediatric Illness
Section snippets
Evaluating Chronically Ill Children and Adolescents
Three aspects of psychiatric consultation in the medically and surgically ill that are specific to working with youth are (1) an awareness of the cognitive and emotional developmental levels of the patient, (2) the essential role of the family, and (3) a focus on facilitating coping and adjustment to illness to follow an optimal developmental trajectory, rather than a focus on psychopathology. Clinicians must be familiar with normal physical, motor, language, cognitive, sexual, and emotional
Impaired Growth and Development and Impact of Chronic Steroid Use
Physical growth is a dynamic process that starts at conception and ends after full pubertal development [12]. Chronic illness may lead to growth retardation, either because of the illness itself or because of treatments required for it. Short stature commonly is perceived to be associated with social and psychologic disadvantage [13]. Parents often attribute behavioral disorders, anxiety, depression, social, and attentional problems to short stature and are concerned that their children are
Psychosocial Considerations
Normative developmental tasks throughout childhood center on developing a sense of self and acquiring autonomy in all areas of life. When compared with their cohort in the general population, however, young adults who are chronically ill with a wide variety of disorders have lower academic and employment achievement, receive less vocational education and have less permanent employment [45], are more likely to be single [46], and have delayed independence [3]. Cohorts have not been followed long
Psychiatric Consequences
Investigations of psychiatric disorders in pediatric conditions have been limited by small and varied demographic samples, lack of consistent testing measurements, frequent subthreshold Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnoses, and lack of appropriate control groups. The full range of developmental and childhood psychiatric disorders, including adjustment disorder, major depression, anxiety, and delirium, are seen in children and adolescents who
Transition to Adult Care
Adolescence is a complex period of transition from childhood to adulthood. Having a chronic illness adds to the complexity (Table 1). Issues of puberty, autonomy, personal identity, sexuality, education, and vocational choices become more difficult for an adolescent who also is coping with chronic illness. This period may be complicated further by medical setbacks, impaired physical or mental abilities, forced dependence, and perceived poor prognosis [76]. For adolescents who have a chronic
Summary
There are many challenges in coping with and adapting to life with a chronic disease, and increased survival cannot be assumed to be associated with increased quality of life. A recent systematic review shows there is wide variation in outcomes depending on the definitions and measurements used to estimate the prevalence of chronic health conditions, making the impact of disability on children's health and social functioning difficult to assess; various authors have called for an international
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2023, Medical Journal Armed Forces IndiaCitation Excerpt :Quality of life (QoL) is the feeling of overall life satisfaction, as determined by the mentally alert individual whose life is being evaluated.1 It is adversely affected in chronic diseases with associated treatment dependence and high complication rates.2 Taking care of a child with a chronic disorder is emotionally, financially, psychologically challenging, and socially limiting.2
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2020, Progress in Pediatric CardiologyCitation Excerpt :Wernovsky et al. [15] outline some of the physical limitations, medication regime, aftercare, and family burden, once the Fontan procedure has been completed. Recent studies emphasise the higher incidence of psychiatric comorbidity in adolescents with single ventricle CHD and the importance of providing psychological and psychiatric support once the physical needs are managed [16–18]. Studies have demonstrated that parents experience higher levels of stress and mental health difficulties than those with typically developed children [19–25].
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This research was supported in part by the National Institute of Mental Health. Dr. Pao's views are her own and do not necessarily reflect the opinions of the United States government.