Table 1

 Reciprocal effects of chronic illness or disability and adolescent development68–72

Effects of chronic illness or disability on developmentEffects of developmental issues on chronic illness or disability
Biological Biologically
Delayed/impaired pubertyIncreased caloric requirement for growth may negatively impact on disease parameters
Short staturePubertal hormones may impact on disease parameters (e.g. growth hormone impairs metabolic control in diabetes)
Reduced bone mass accretion
Psychological Poor adherence and poor disease control due to:
InfantilisationPoorly developed abstract thinking and planning (reduced ability to plan and prepare using abstract concepts)
Adoption of sick role as personal identifierDifficulty in imagining the future; self-concept as being “bullet proof”
Egocentricity persists into late adolescenceRejection of medical professionals as part of separation from parents
Impaired development of sense of sexual or attractive selfExploratory (risk taking) behaviours
Impaired development of cognitive functions and information processing
Social Associated health risk behaviours
Reduced independence at a time of when independence is normally developingChaotic eating habits may result in poor nutrition
Failure of peer relationships then intimate (couple) relationshipsSmoking, alcohol and drug use often in excess of normal population rates
Social isolationSexual risk taking, possibly in view of realisation of limited life span
Educational failure and then vocational failure; failure of development of independent living ability