Ferro Mark A, Lipman Ellen L, Van Lieshout Ryan J, Gorter Jan Willem, Shanahan Lilly, Boyle Michael, Georgiades Kathy, Timmons Brian
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
BMJ Open. 2019 Nov 3;9(11):e034544. doi: 10.1136/bmjopen-2019-034544.
Multimorbidity, the co-occurrence of a chronic physical condition and mental disorder, affects a substantial number of children and youth and can lead to compromised quality of life, hardship for families, and an increased burden on the healthcare system. We are conducting a study to document the course of mental disorder in children and youth diagnosed with a chronic physical condition; identify predictors of child and youth multimorbidity; examine whether the effects of these predictors are moderated by relevant psychosocial and biological factors; explore potential inflammatory and stress biomarkers that mediate the onset of child and youth multimorbidity; and, assess whether multimorbidity in children and youth alters patterns of mental health service use.
Multimorbidity in Children and Youth Across the Life-course (MY LIFE) is a prospective study. Two hundred and fifty children and youth aged 2-16 years diagnosed with a chronic physical condition along with one parent will be recruited from the outpatient clinics at a paediatric tertiary care centre. Data will be collected using a multi-informant, multimethod design at four time-points (at recruitment, and at 6, 12 and 24 months postrecruitment). Parents will provide reports for all children/youth. In addition, youth ≥10 years will self-report. Mental disorder will be assessed using structured interviews. On completion of data collection, participant-reported data will be linked to provincial health records to identify mental health services use. Multilevel analyses (survival, proportional hazard, structural equation modelling) will be used to address MY LIFE objectives.
This study has been approved by the University of Waterloo Human Research Ethics Board and the Hamilton Integrated Research Ethics Board. Findings will be disseminated to key stakeholders using a number of outlets (peer-reviewed publications and conferences, lay informational pamphlets, social media).
多种疾病并存,即慢性身体疾病与精神障碍同时出现,影响着大量儿童和青少年,可能导致生活质量下降、家庭困难以及医疗系统负担加重。我们正在开展一项研究,以记录被诊断患有慢性身体疾病的儿童和青少年的精神障碍病程;确定儿童和青少年多种疾病并存的预测因素;研究这些预测因素的影响是否会受到相关心理社会和生物学因素的调节;探索介导儿童和青少年多种疾病并存发病的潜在炎症和应激生物标志物;以及评估儿童和青少年的多种疾病并存是否会改变心理健康服务的使用模式。
“儿童和青少年一生的多种疾病并存(MY LIFE)”是一项前瞻性研究。将从一家儿科三级护理中心的门诊招募250名2至16岁被诊断患有慢性身体疾病的儿童和青少年及其一名家长。将在四个时间点(招募时、招募后6个月、12个月和24个月)采用多信息提供者、多方法设计收集数据。家长将为所有儿童/青少年提供报告。此外,10岁及以上的青少年将进行自我报告。将使用结构化访谈评估精神障碍。在数据收集完成后,参与者报告的数据将与省级健康记录相链接,以确定心理健康服务的使用情况。将使用多水平分析(生存分析、比例风险分析、结构方程模型)来实现MY LIFE的目标。
本研究已获得滑铁卢大学人类研究伦理委员会和汉密尔顿综合研究伦理委员会的批准。研究结果将通过多种渠道(同行评审出版物和会议、通俗信息手册、社交媒体)传播给主要利益相关者。