Agreement of child and parent-proxy reported health-related quality of life in children with mental disorder

Qual Life Res. 2019 Mar;28(3):703-712. doi: 10.1007/s11136-018-2026-x. Epub 2018 Oct 16.


Purpose: The purpose of the study was to test whether elevated levels of depressive and anxiety symptoms affect parent-proxy reports of health-related quality of life (HRQL) of children with mental disorder.

Methods: A sample of 114 children, who screened positive for mental disorder using the Mini International Neuropsychiatric Interview were studied. Parents' depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D) and anxiety symptoms using the State Trait Anxiety Inventory (STAI). To examine whether parental psychopathology moderated their reports of child HRQL (using the KIDSCREEN-27), a series of multiple regression analyses with product-term interactions were conducted.

Results: Significant interactions were found for the moderating effect of parental depressive [β = 0.025 (0.007, 0.042)] and anxiety symptoms [β = 0.033 (0.011, 0.054)] on the domain of child social support and peers relations, as well as for the moderating effect of parental levels of depression on parent proxy child physical well-being [β = - 0.017 (- 0.031, - 0.003)]. Parents with elevated levels of depressive or anxiety symptoms reported lower scores for those domains of child HRQL.

Conclusions: Symptoms of depression and anxiety in parents influence their reports of the HRQL of their children with mental disorder, particularly in the areas of physical well-being and social support and peers. Given the importance of patient-reported outcomes in the assessment and monitoring of children with chronic conditions, including HRQL, health professionals caring for children with mental disorder should be aware of how parental psychopathology contributes to informant bias. Future research examining why psychopathology influences parental reports of child HRQL is warranted.

Keywords: Anxiety; Depression; Informant bias; Mental disorder; Proxy report.

MeSH terms

  • Adolescent
  • Anxiety / psychology*
  • Child
  • Child, Preschool
  • Depression / psychology*
  • Female
  • Humans
  • Male
  • Parents / psychology*
  • Proxy
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / pathology
  • Psychotic Disorders / psychology*
  • Quality of Life / psychology*