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Chronic illness and disability

2005; BMJ; Volume: 330; Issue: 7493 Linguagem: Inglês

10.1136/bmj.330.7493.721

0959-8138

Michele Yeo, Susan M. Sawyer,

Pharmaceutical studies and practices

Young people with chronic conditions often face more difficulties negotiating the tasks of adolescence than their healthy peers.National, population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.However, 10-13% of teenagers report having a chronic condition that substantially limits their daily life or requires extended periods of care and supervision.The burden of chronic conditions in adolescence is increasing as larger numbers of chronically ill children survive beyond the age of 10.Over 85% of children with congenital or chronic conditions now survive into adolescence, and conditions once seen only in young children are now seen beyond childhood and adolescence.In addition, the prevalence of certain chronic illnesses in adolescence, such as diabetes (types 1 and 2) and asthma, has increased, as has survival from cancer. Impact of chronic conditions on adolescenceChronic conditions in adolescence can affect physical, cognitive, social, and emotional spheres of development for adolescents, with repercussions for siblings and parents too. Physical effectsCommon sequelae of chronic illness and its treatment include short stature and pubertal delay.Undernutrition is common in many chronic conditions, and obesity can result from conditions that limit physical activity.Visible signs of illness or its treatment mark young people out as different at a time when such differences are important to young people and their peers.Body image issues related to height, weight, pubertal stage, and scarring can contribute to reduced self esteem and negative self image, problems that may persist into adult life. Emotional and mental healthMany young people cope well with the emotional aspects of having a chronic illness.Chronically ill young people are more likely, however, to have a lower level of emotional wellbeing than their healthy peers.Young people often report a sense of alienation from their peers and frustration with the requirements of managing their condition and negotiating the healthcare system.Young people with chronic illness do not have an increased rate of mental illness, as is the case in adults with chronic illness.However, because those with chronic illness experience many sources of stress, health professionals must be alert for depression, anxiety, and adjustment disorders both in young people and in their families.Behavioural problems and declining school performance can be specific markers of underlying psychological distress in adolescence.