Applying a developmental approach to quality of life assessment in children and adolescents with psychological disorders: challenges and guidelines

Abstract

Research on the quality of life (QL) of children/adolescents with psychological disorders has flourished over the last few decades. Given the developmental challenges of QL measurements in pediatric populations, the aim of this study was to ascertain the extent to which a developmental approach to QL assessment has been applied to pedopsychiatric QL research. A systematic literature search was conducted in three electronic databases (PubMed, PsycINFO, SocINDEX) from 1994 to May 2014. Quantitative studies were included if they assessed the self- or proxy-reported QL of children/adolescents with a psychological disorder. Data were extracted for study design, participants, QL instruments and informants, and statistical approach to age-related specificities. The systematic review revealed widespread utilization of developmentally appropriate QL instruments but less frequent use of both self and proxy reports and an inconsistent approach to age group specificities. Methodological guidelines are discussed to improve the developmental validity of QL research for children/adolescents with mental disorders.

Keywords:

• children and adolescents
• developmental approach
• patient- and proxy-reported outcomes
• pediatric psychological disorders
• pedopsychiatry
• quality of life assessment

Financial & competing interests disclosure

This work was conducted within the Relationships, Development & Health Research Group of the R&D Unit Cognitive-Behavioral Centre for Research and Intervention (PEst-OE/PSI/UI0730/2014). N Silva and H Moreira were supported by the Portuguese Foundation for Science and Technology under grants SFRH/BD/69885/2010 and SFRH/BPD/70063/2010, respectively. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• School-aged children (8–12 years) and adolescents (13–18 years) pose unique developmental challenges to the assessment of their quality of life (QL).

• Children and adolescents with psychological disorders have significant QL impairments that go beyond their psychopathological symptoms.

• QL measurements should be integrated into pedopsychiatric assessments and intervention processes along with psychopathological measures.

• A developmental approach to QL assessment implies the administration of developmentally appropriate instruments, the acknowledgment of age group specificities and the inclusion of both self-reports and proxy reports.

• School-aged children and adolescents with psychological disorders share common QL markers, but their age group specificities should not be neglected in QL measurements.

• Self and proxy sources for pedopsychiatric QL assessment should be assumed to be complementary to each other rather than mutually exclusive.

• QL measures broaden the scope of pedopsychiatric assessments and are thus likely to improve the effectiveness of intervention processes.

• QL assessments may facilitate case formulation by mapping individual and contextual aspects that may act as predisposing, precipitating and/or perpetuating factors for child and adolescent psychopathology.

• Developmentally appropriate QL assessments are practical means of empowering children and adolescents with mental disorders as well as their parents by actively involving them in a strength-based approach to psychotherapeutic processes.

Notes