Study: Physical limits hurt mental health

John Adams, MD, of the Cambridge Health Alliance in Massachusetts.

Children and young adults with physical conditions like diabetes, ADHD, and asthma are more likely to develop mental health problems according to a U.S. study.

The study, led by John Adams, MD, of the Cambridge Health Alliance in Massachusetts, followed 48,572 young people ages 6 to 25 over a two-year-period.

The individuals followed did not have mental health issues at the start of the research, but 14.7 percent were coping with physical problems that required treatment or limited their daily life activities.

During the course of the study, overall, 7.8 percent of the participants developed a mental health problem. (Broken down further, that’s 11.5 percent of youth with physical problems and 7.1 percent without.)

Children and young adults with chronic physical ailments were 51 percent more likely to be diagnosed with mental health issues like depression, anxiety, and behavior disorders.

The study found that young people were 51 percent more prone to develop anxiety, 70 percent more likely to develop mood disorders and 54 percent more likely to develop behavior disorders.

“Having limitations from a physical illness can be a predictor of mental health conditions,” noted Adams, who is a primary care physician at CHA and a clinical instructor at Mass General Hospital for Children.

Adams said he was surprised that so few participants (1.8 percent) reported activity limitations. The results showed kids with health problems are three times more likely to have limitations than the other survey participants.

However, the research relied on surveys of parents to gather data, a process that Adams said is a drawback to the study because their reporting may not always be entirely accurate.

Nonetheless, the study indicated that living with physical ailments takes a psychological toll that gets worse as time goes on.

The rates of mental health diagnoses increased from 5.6 percent among children ages six to 11 to 7.4 percent for youth ages 12 to 18. The rate rose to 10.1 percent for young adults ages 19 to 25.

Adams emphasized the association between not being able to engage in developmentally appropriate activities, such as at school or work, and a psychological impact.

“It highlights a risk factor that could help future efforts to prevent mental illness in this age group,” Adams said.

He said that parents and physicians can be “vigilant,” and on the lookout for signs that the child is struggling emotionally as well as physically. Early detection and then intervention would be helpful.

“This is an area we should work to try to mitigate,” he said.

He acknowledged that the study’s two-year span may not be long enough to get the complete picture. Mental health disorders may not be apparent yet, especially in the youngest age group.

The research appeared in Pediatrics in June.

Other researchers were Alyna T. Chien, MD, MS, and Lauren E. Wisk, Ph.D.