Abstract
BackgroundChildren with mental health problems have been neglected in health-related quality of life (HRQOL) studies. Therefore, the aims of the current study were 1) to assess the influence of the presence of mental or physical health problems on HRQOL; and 2) to analyze the effects of item overlap between mental health problems and HRQOL-measurements.MethodsProxy- and self-rated HRQOL (KIDSCREEN-27) of children 9–14 years old was assessed across children with mental health problems (n = 535), children with physical health problems (n = 327), and healthy controls (n = 744). Multiple linear regression analyses were conducted with health status, severity of symptoms, status of medication use, gender and nationality as independent, and HRQOL scores as dependent variables. The effects of item overlap were analyzed by repeating regression analyses while excluding those HRQOL items that contextually overlapped the most frequently-occurring mental health problem (attention deficits).ResultsSeverity of symptoms was the strongest predictor of reduced HRQOL. However, all other predictors (except for the status of medication use) also contributed to the prediction of some HRQOL scores. Controlling for item overlap did not meaningfully alter the results.ConclusionsWhen children with different health constraints are compared, the severity of their particular health problems should be considered. Furthermore, item overlap seems not to be a major problem when the HRQOL of children with mental health problems is studied. Hence, HRQOL assessments are useful to gather information that goes beyond the clinical symptoms of a health problem. This information can, for instance, be used to improve clinical practice.
Highlights
Children with mental health problems have been neglected in health-related quality of life (HRQOL) studies
For the ‘physical well-being’ subscale, children with special health care needs (CSHCN) with physical health problems had the lowest scores, whereas CSHCN with mental health problems had the lowest scores for all other Health-related quality of life (HRQOL) scales
The presence of mental health constraints was significantly associated with a poorer ‘school environment’ when self reports were considered, and tended towards poorer ‘school environment’ when parent reports were used. The effect on this subscale may be due to the composition of our sample, as the most frequently-reported mental health problems were attention deficits, learning difficulties and conduct problems, problems that share their strong impact upon school context. It seems that this impact was not entirely attributable to content similarities between the conceptualization of mental health problems and HRQOL items, because our results remained largely unchanged even when we controlled for item overlap
Summary
The aims of the current study were 1) to assess the influence of the presence of mental or physical health problems on HRQOL; and 2) to analyze the effects of item overlap between mental health problems and HRQOL-measurements. Addressing existing research gaps and the aforementioned limitations, the aims of the present study were twofold: First, we aimed to assess the influence of mental health problems on proxy- and self-rated HRQOL scores in a population-based sample. We aimed to examine whether item overlap effects the association between mental health problems and HRQOL. The purpose of this article was to evaluate the HRQOL of children with mental health problems in-depth
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