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Physical health and mental healthcare: each has its own evidence base but they need to be integrated
  1. Isobel Heyman1,2
  1. 1UCL Great Ormond Street Institute of Child Health, London, UK
  2. 2Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Isobel Heyman, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London WC1N 1EH, UK; i.heyman{at}

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Children with long-term physical health conditions have higher rates of emotional and behavioural difficulties than the general population. This has been known for very many years—for example, since the pioneering of epidemiological studies of Michael Rutter on the Isle of Wight in the 1970s where children with epilepsy were shown to have up to six times the rate of common child mental health disorders. This has been replicated in many population and clinical studies since.1 But establishing the mechanisms of this increased risk continues to be elusive, and more importantly, clinical and research communities need to devise ways of providing accessible integrated services to this population of children—to effectively treat their well-being and mental health needs together with their physical heath difficulties.

It is therefore very welcome to see greatly increased interest in integrating physical and mental healthcare for children—mind and body care, including the current paper by O’Connell et al.2

Following their pilot study, which suggested that pump therapy enhanced psychological outcomes as well as improving diabetic control, the team sought to pin down the evidence in the published randomised controlled trial. While there was short-term (at 4 months’ follow-up) improvement in behaviour and in diabetic control, these gains were not sustained at the impressive follow-up which was carried …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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