Youth with serious illness struggle with anxiety, depression

  • JAMA Pediatr

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Young people with life-limiting conditions such as thalassemias, chronic kidney disease, or neurological conditions have high prevalences of anxiety and depression, especially as they get older.
  • Meta-analysis finds 6-fold anxiety prevalence and higher depression prevalence in this population compared with unaffected counterparts.

Why this matters

  • Editorial: the study confirms what most practitioners know, and these findings underscore the need for commitment and funding by specialty centers for assessing and supporting these patients. 

Key results

  • 19 of 37 included studies reported anxiety prevalence, 36 reported depression prevalence.
  • Mean participant age: 15.4 (6-25) years.
  • Anxiety prevalence: 19.1% (95% CI, 14.1%-24.6%).
    • Range among studies: 3.6% (95% CI, 0.4%-12.5%) to 58.3% (95% CI, 36.6%-77.9%).
    • Highest prevalences with thalassemias, cystic fibrosis.
    • Higher values with diagnostic interviews vs self or parent report.
  • Depression prevalence: 14.3% (95% CI, 10.5%-18.6%).
    • Range among studies: 0.0% (95% CI, 0.0%-0.7%) to 50.0% (95% CI, 34.9%-65.1%).
    • Higher values among those with HIV, increasing age.
  • Heterogeneity among studies was high.
  • Bias risk, moderate-low.

Study design

  • Meta-analysis, systematic review of 37 studies with 6042 participants (range, 20-2032).
  • Funding: Martin House Hospice Care for Children and Young People; University of York.

Limitations

  • Many studies were small.
  • Reporting of demographic data was poor.