91 Mental Health Burden of Adolescents with Dysautonomia

Abstract

Abstract Background Dysautonomia of Adolescence (DAOA) results from a dysregulation of the autonomic nervous system during puberty and affects multiple organ systems in the body. Symptoms have a significant impact on quality of life (QoL) with many adolescents reporting a poorer QoL compared to other pediatric chronic illness populations. Furthermore, there is a paucity of research looking at underlying mental health conditions in patients with DAOA that might be contributing to poor QoL. Objectives The aim of this review was to characterize the underlying mental health status of patients with DAOA followed in a tertiary care DAOA Clinic. Design/Methods Single-centre retrospective chart review (January 2017-November 2019) of all current patients followed in a tertiary care DAOA Clinic. Mental health challenges were classified as significant symptoms reported and/or formal diagnosis of anxiety, depression, attention deficit hyperactivity disorder, obsessive compulsive disorder, eating disorders, somatization, mood disorders, suicidal ideation, and self-harm. Frequency tables were generated for all categorical variables. Results Seventy-three patients are currently being followed in the DAOA clinic. Fifty-five of 73 (75%) had some form of mental health challenge including 11 (15%) which had a history of suicidal ideation and/or self-harm, 12 (17%) had no mental health concerns, and 6 (8%) are unknown. Of the 55 patients with a mental health challenge, 27 (49%) were diagnosed with a mental health condition prior to formal DAOA diagnosis and 10 (18%) were diagnosed after DAOA diagnosis. Eighteen (14%) reported symptoms of a mental health challenge but no confirmed mental health diagnosis. A breakdown of mental health symptoms and diagnoses are shown in Table 1. Of the 73 current patients, 41 (56%) accessed psychology services either through the DAOA Clinic or in the community, 9 (12%) have been referred to other health care services, and 8 (11%) did not access services. Psychiatric services were required by 15 patients (21%). Conclusion Three-quarters of DAOA patients report some mental health challenges. This emphasizes the need for psychology to support patients with DAOA. It is unclear as to whether a mental health challenge exacerbates symptoms of DAOA or DAOA symptoms negatively impact their mental health.