Abstract
(1) Background: Health-related quality of life (HRQoL) is frequently reduced in children of parents with a mental illness (COPMI). Child self- and parent proxy-ratings vary with raters’ characteristics and facets of HRQoL. This study aimed at analyzing risk and protective factors associated with HRQoL in COPMI, and at examining the magnitude, direction, and predictors of child–parent agreement. (2) Methods: Analyses were based on baseline data of the German CHIMPS (children of parents with a mental illness) project with n = 134 parents diagnosed with mental illness and n = 198 children and adolescents aged 8 to 18 years. (3) Results: Both children and parents reported significantly lower HRQoL than the reference population, particularly for the child’s physical and psychological well-being. Parents’ proxy-report indicated a lower HRQoL than the children’s self-report. Child and parental psychopathology, social support, and the child’s age significantly predicted HRQoL. Interrater agreement was satisfactory and better for observable aspects like physical well-being and school environment. The child’s gender-identity and mental health significantly predicted child–parent agreement. (4) Conclusions: Parental psychopathology significantly reduces children’s HRQoL. Interventions should promote resilience in children by targeting risk and protective factors. Child–parent agreement emphasizes the need to obtain both self- and proxy-reports, whenever possible.
Highlights
Codes: mental and behavioral disorders due to psychoactive substance use (F10–F19), schizophrenia, schizotypal, and delusional disorders (F20–F29), mood disorders (F30–F39), neurotic, stress-related and somatoform disorders (F40–F48), disorders of adult personality and behavior (F60–F69), behavioral and emotional disorders with onset usually occurring in childhood and adolescence (F90–F98); b Brief Symptom Inventory (BSI); c Freiburg
Our findings suggest that Health-related quality of life (HRQoL) is impaired in children of parents with a mental illness (COPMI)
Interventions should concentrate on the children’s psychological and physical well-being, as these seem to be the most impaired facets. To improve these domains of children’s HRQoL, interventions should focus on the whole family
Summary
The psychological burden of parental mental illness may lead to emotional and behavioral difficulties in children, and has a more general influence on the children’s social relationships, interests, and academic environment, and may affect the children’s overall well-being and life satisfaction. Health-related quality of life (HRQoL) has been increasingly considered as an outcome criterion for children and adolescents to determine the burden of such demanding family conditions [2]. It has been defined as a subjective, multidimensional construct that compromises physical, psychological and social well-being [3].
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