What is known about the association between Illness Perceptions and Mental Health in Children and Young People with Long-Term Health Conditions: A Scoping Review.

Abstract

Background: Long-Term Conditions (LTCs) are the most common physical illness for children and young people (CYP), with an estimated prevalence of 10-20% of CYP experiencing an LTC. CYP with LTCs are four times more likely to experience a mental health disorder compared to their physically healthy peers. To know how best to support mental health in CYP with LTCs, we need an understanding of potential protective or predictive factors of their mental health. One such factor, which is potentially modifiable, is illness perceptions, yet no review has been undertaken to explore how mental health and illness perceptions interact in CYP with an LTC. Methods: A scoping review was conducted to investigate what is known about the associations between illness perceptions and mental health in CYP with LTCs. All types of quantitative studies which investigated these associations in any LTC, either cross-sectionally or longitudinally, were included. Psychinfo, Embase, Medline, Web of Science and the Cochrane Library were searched, and a quality assessment completed for all included studies. Two reviewers screened citations for inclusion. Data abstraction was performed by one reviewer. The principles of thematic analysis were applied to the extracted information to synthesise the findings (narrative synthesis). Results: Thirty-two studies were included (n = 4026 participants), comprised of twenty-five cross-sectional studies and seven longitudinal studies. Studies included a range of LTCs and were from several countries. There was consistent evidence of predominantly moderate and large associations (r ≥ 0.25), in which more negative illness perceptions associated with worse mental health outcomes. These applied across a range of LTCs, both cross-sectionally and longitudinally.Conclusions: The consistent evidence of associations between mental health and illness perceptions in CYP with LTCs found in this review, suggests that illness perceptions could be an important factor in how CYP experience their LTC and the co-morbid difficulties around this (i.e., their mental health). Further research is needed to continue to explore this relationship and the potentially modifiable or protective nature of this relationship, to inform future care for individuals with LTCs. Limitations are discussed. Key Terms: Children and Young People; Long-term Condition; Illness Perceptions; Mental Health