Psychological complications of chronic illness

Having a chronic illness—an illness that lasts for a significant period of time, and requires ongoing medical care—can be incredibly taxing for adults, and even more so for children.

A child or teen already dealing with the normal changes and stresses of growing up experiences further complications when facing a chronic illness like asthma, attention-deficit hyperactivity disorder (ADHD) or diabetes. 

Chronic medical disorders, and the treatments that go along with them, can:

• intensify a child’s concerns about her physical appearance
• interfere with her process of gaining independence
• disrupt her evolving relationships with parents and friends
• make it hard for her to manage her illness on a daily basis

At Children’s Hospital Boston, we understand that children (and families) who are confronting chronic physical illness, medical procedures and hospitalizations are often confused and anxious. Our experienced team of psychiatrists, psychologists, social workers and other mental health professionals is here to complement your child’s medical care. We can help your child and family cope through:

• education about the psychological impact of chronic illness for the child, family and other medical caregivers
• psychotherapy (“talk therapy”) to identify, understand and balance the emotional toll of a chronic illness
• if necessary, antidepressant or anti-anxiety medication in conjunction with talk therapy 

How Boston Children's Hospital approaches psychological complications of chronic illness

Children’s Hospital Boston has long been at the forefront of providing expert and compassionate medical, mental and behavioral health care for children and adolescents. Our Department of Psychiatry team members are leaders in researching, diagnosing and treating the full spectrum of mental health conditions that affect kids and families, including: 

• depression
• anxiety disorders
• bipolar disorder
• eating disorders
• post-traumatic stress disorder (PTSD)  

The Department offers special expertise in helping children and families cope with the emotional toll of a chronic medical condition. Our initiatives in this vital area include: 

• Our Behavioral Medicine Clinic works with children who are being treated on an outpatient basis at the hospital—as well as their families—so they can understand and manage their feelings about:
  • being sick
  • facing uncomfortable procedures
  • handling pain
  • taking medication
  • preparing for surgery
  • changes in friendships and family relationships
  • managing school while dealing with an illness
  • grief and loss
     
• Our Psychiatry Consultation Service is comprised of expert and compassionate mental health professionals who understand the unique circumstances of hospitalized children and their families. The team provides several services for children who have been admitted to the hospital, including:
  • short-term therapy for children admitted to one of our inpatient units
  • parent and sibling consultations
  • teaching healthy coping skills for the whole family
  • educating members of the medical treatment team about the relationship between physical illness and psychological distress

• Children’s psychiatrist-in-chief David DeMaso, MD, and his colleagues have developed the Experience Journal, an online collection of stories, drawings and words of wisdom from children, parents and caregivers affected by chronic illness.
   
• To help teenagers take a more proactive role in their treatment and to have their needs recognized, Children’s has developed the  Teen Advisory Committee. The group—comprised of current Children’s patients, ages 14 to 21—serves as a team of peers who can listen to other patients’ needs, ensure their voices are heard and advocate for change.

Psychological complications of chronic illness: Reviewed by David R. DeMaso, MD
© Children’s Hospital Boston; posted in 2011