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.