Health-related quality of life in children with neurofibromatosis type 1: contribution of demographic factors, disease-related factors, and behavior

J Pediatr. 2009 Mar;154(3):420-5, 425.e1. doi: 10.1016/j.jpeds.2008.08.045. Epub 2008 Oct 31.


Objective: To investigate health-related quality of life (HR-QOL) in children with neurofibromatosis type 1 (NF1) with parental reports and children's self-reports, and to investigate the potential contribution of demographic factors, disease-specific factors, and problems in school performance or behavior.

Study design: In a prospective observational study, parents of 58 children with NF1 (32 boys, 26 girls, age 12.2 +/- 2.5 years) visiting a university clinic, and their 43 children 10 years or older were assessed with the Child Health Questionnaire (CHQ). Potential determinants of domain scores were assessed in 3 explorative regression models.

Results: Parents reported a significant impact of NF1 on 9/13 CHQ scales, with moderate effect sizes on 8 (general health perceptions, physical functioning, general behavior, mental health, self esteem, family activities, role functioning emotional/behavioral, and parent emotional impact). Children report an impact on bodily pain, and an above average general behavior. Multiple CHQ scales were sensitive to demographic factors and behavioral problems, and 1 to NF1 severity. NF1 visibility and school problems did not influence HR-QOL.

Conclusions: Parents, but not the children with NF1, report a profound impact of NF1 on physical, social, behavioral, and emotional aspects of HR-QOL. Multiple HR-QOL domains were most sensitive to behavioral problems, which points to an exciting potential opportunity to improve HR-QOL in children with NF1 by addressing these behavioral problems.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Achievement
  • Adaptation, Psychological
  • Adolescent
  • Attitude to Health*
  • Child
  • Child Behavior Disorders / complications
  • Child Welfare
  • Demography
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Male
  • Mental Health
  • Neurofibromatosis 1 / complications
  • Neurofibromatosis 1 / psychology*
  • Pain / complications
  • Pain / psychology
  • Parent-Child Relations
  • Parents
  • Prospective Studies
  • Quality of Life*
  • Self Concept
  • Stress, Psychological / etiology
  • Surveys and Questionnaires