Claire Buchan M, Whitney Sydney, Leatherdale Scott T, Mielke John G, Gonzalez Andrea, Ferro Mark A
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Chronic Stress (Thousand Oaks). 2021 Oct 12;5:24705470211047885. doi: 10.1177/24705470211047885. eCollection 2021 Jan-Dec.
Children living with mental disorder are at risk for lower health-related quality of life (HRQoL) compared to their peers. While evidence suggests that cortisol dysregulation is implicated in the onset of mental disorder, the extent to which cortisol is associated with HRQoL is largely unknown. Further, it remains unknown how comorbid physical illness may alter this relationship. This study examined whether the presence of a comorbid physical illness moderated the association between hair cortisol concentration (HCC) and HRQoL among children with mental disorder.
One-hundred children (4-17 years) receiving care from a pediatric hospital were recruited. The Mini International Neuropsychiatric Interview was used to measure mental disorder and the KIDSCREEN-27 to assess HRQoL. Cortisol extracted from children's hair was assayed using high-sensitivity ELISA. Multiple regression analyses tested the association between HCC and HRQoL.
Presence of a physical illness was found to moderate the relationship between HCC and HRQoL in the domain of peers and social support [comorbidity: β = -0.57 (-0.97, -0.17); no comorbidity: β = 0.22 (-0.11, 0.55)].
The association between HCC and HRQoL in children with mental disorder is moderated by the presence of a physical illness, such that in children with comorbid physical and mental disorder, elevated HCC is associated with lower HRQoL. Approaches that reduce stress in these children may help promote optimal well-being. More research investigating physiological stress and psychosocial outcomes in children with mental disorder, particularly those with comorbid physical illness, is needed.
与同龄人相比，患有精神障碍的儿童健康相关生活质量（HRQoL）较低。虽然有证据表明皮质醇调节异常与精神障碍的发病有关，但皮质醇与HRQoL的关联程度在很大程度上尚不清楚。此外，合并身体疾病如何改变这种关系仍不清楚。本研究调查了合并身体疾病是否会调节精神障碍儿童头发皮质醇浓度（HCC）与HRQoL之间的关联。
招募了100名（4至17岁）在儿科医院接受治疗的儿童。使用迷你国际神经精神病学访谈来测量精神障碍，并用儿童生活质量量表27项版（KIDSCREEN - 27）来评估HRQoL。使用高灵敏度酶联免疫吸附测定法（ELISA）检测从儿童头发中提取的皮质醇。多元回归分析测试了HCC与HRQoL之间的关联。
发现身体疾病的存在会调节HCC与同龄人及社会支持领域的HRQoL之间的关系[合并症：β = -0.57（-0.97，-0.17）；无合并症：β = 0.22（-0.11，0.55）]。
身体疾病的存在会调节精神障碍儿童HCC与HRQoL之间的关联，即患有身心合并症的儿童中，升高的HCC与较低的HRQoL相关。减轻这些儿童压力的方法可能有助于促进最佳健康状态。需要更多研究来调查精神障碍儿童，特别是那些患有合并身体疾病的儿童的生理应激和心理社会结果。
