EDGE Lab, School of Psychology, University of Sussex, Brighton, UK.
Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
J Child Psychol Psychiatry. 2017 Jul;58(7):753-769. doi: 10.1111/jcpp.12727. Epub 2017 Apr 27.
Childhood chronic physical illness is associated with a greater vulnerability for emotional problems (i.e. depression and anxiety) in childhood. However, little is known about life-long effects of childhood chronic physical illness on mental health. The present study aims to systematically review evidence for associations between eight chronic physical illnesses with childhood onset (arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type 1 diabetes, and epilepsy) and adult emotional problems.
A database search of MEDLINE, PsycARTICLES, PsycINFO, and ScienceDirect was undertaken, and random effects meta-analyses were used to synthesise evidence from eligible studies.
In total, 37 studies were eligible for the systematic review (n = 45,733) and of these, 34 studies were included in the meta-analyses (n = 45,358). There were overall associations between childhood chronic physical illness and adult depression (OR = 1.31; 95% CI [1.12, 1.54]) and anxiety (OR = 1.47; 95% CI [1.13, 1.92]). Separate meta-analyses for childhood asthma, type 1 diabetes and cancer were also conducted, with cancer being significantly associated with adult depression (OR = 1.19; 95% CI [1.00, 1.42]).
The effects of childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence. Mental health prevention and intervention strategies targeting children with chronic physical illnesses can have long-term benefits.
儿童期慢性躯体疾病与儿童时期情绪问题（即抑郁和焦虑）的易感性增加有关。然而，对于儿童期慢性躯体疾病对心理健康的终身影响知之甚少。本研究旨在系统回顾儿童期发病的八种慢性躯体疾病（关节炎、哮喘、癌症、慢性肾衰竭、先天性心脏病、囊性纤维化、1 型糖尿病和癫痫）与成年期情绪问题之间关联的证据。
对 MEDLINE、PsycARTICLES、PsycINFO 和 ScienceDirect 数据库进行了检索，并使用随机效应荟萃分析综合了合格研究的证据。
共有 37 项研究符合系统评价的纳入标准（n=45733），其中 34 项研究纳入荟萃分析（n=45358）。儿童期慢性躯体疾病与成年期抑郁（OR=1.31；95%CI[1.12,1.54]）和焦虑（OR=1.47；95%CI[1.13,1.92]）存在总体关联。还对儿童期哮喘、1 型糖尿病和癌症进行了单独的荟萃分析，结果显示癌症与成年期抑郁显著相关（OR=1.19；95%CI[1.00,1.42]）。
儿童期慢性躯体疾病对情绪问题风险的影响持续到儿童期和青春期之后。针对患有慢性躯体疾病的儿童的心理健康预防和干预策略可以带来长期益处。
