The association between mental health and quality of life in adolescents with anorectal malformations or Hirschsprung disease.

BACKGROUND

Adolescents with anorectal malformations (ARM) or Hirschsprung disease (HD) often experience physical and psychosocial challenges. It remains unclear to what extent PedsQL-Generic Core Scales (PedsQL-GCS) and symptom-specific quality of life (QoL) measures reflect psychiatric symptom burden. This study aimed to investigate differences in patient-reported QoL between adolescents with and without a psychiatric diagnosis and associations between psychiatric symptom burden and QoL in adolescents with ARM or HD.

METHODS

Sixty-eight adolescents (31 ARM, 37 HD; median age 14 years; 45 males) were assessed using the Child Assessment Schedule (CAS), the PedsQL-GCS and the PedsQL Gastrointestinal Symptoms Module (PedsQL-GSM) questionnaires. Group differences and associations were examined.

RESULTS

Nineteen adolescents (28%) had a psychiatric diagnosis (11 ARM, 8 HD). Adolescents with a psychiatric diagnosis reported lower PedsQL-GCS total scores (median 85.0 vs 92.0; p <.01) and PedsQL-GCS psychosocial scores (median 83.0 vs 92.0; p < .01). PedsQL-GSM total score was also lower (median 78.0 vs 97.0; p < .01) in those with a psychiatric diagnosis. Higher CAS symptom scores were moderately associated with lower PedsQL-GCS scores (ρ= -0.51, p< .001), whereas the association with PedsQL-GSM scores was weaker (ρ= -0.33, p=0.021).

CONCLUSION

Both generic QoL and gastrointestinal symptom scores were lower in adolescents with ARM or HD and a psychiatric diagnosis. Regardless of psychiatric diagnosis, psychiatric symptom burden was moderately associated with reduced PedsQL-GCS, including psychosocial domains. Incorporating PedsQL-GCS alongside PedsQL-GSM into long-term follow-up may help identify adolescents with psychosocial difficulties who may benefit from further mental health assessment and follow-up.