Depressive symptoms in children and adolescents with chronic physical illness: an updated meta-analysis

J Pediatr Psychol. 2011 May;36(4):375-84. doi: 10.1093/jpepsy/jsq104. Epub 2010 Nov 18.


Objective: To integrate results of available studies that compared levels of depressive symptoms of children and adolescents with chronic physical illness to healthy peers or test norms.

Methods: Random-effects meta-analysis was computed with 340 studies and 450 subsamples.

Results: Children and adolescents with chronic illness have, on average, higher levels of depressive symptoms than their healthy peers (d = .19 SD units). Differences are strongest for chronic fatigue syndrome (d = .94), fibromyalgia (d = .59), cleft lip and palate (d = .54), migraine/tension head ache (d = .51), and epilepsy (d = .39). Larger effect sizes were found in studies with higher proportion of girls, with a healthy control group, from developing countries, published before 1990, and that used parent rating or clinician ratings rather than child ratings.

Conclusions: Pediatricians and others working with children with chronic illnesses should screen children with chronic physical illness for symptoms of psychological distress and make appropriate referrals for mental health services, when needed.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease / psychology*
  • Depression / diagnosis
  • Depression / psychology*
  • Female
  • Humans
  • Male
  • Mental Health