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UBC Theses and Dissertations

Children of multiple sclerosis : impact of chronic disease in parents on child and adolescnet development Razaz, Neda


Approximately 10% of children live in households where a parent has a chronic illness and many children are exposed to a parent coping with a potentially disabling chronic condition, such as multiple sclerosis (MS). However, few methodologically rigorous studies have evaluated the impact of parental MS on child development. The purpose of this thesis was to fill this knowledge gap by studying the association between parental MS and child and adolescent development. The studies in this dissertation were based on population-based health databases from Manitoba and British Columbia. The cohorts followed in these population-based studies included all individuals with MS who had a child with a completed Early Development Instrument (EDI) school readiness assessment, and matched parent-child dyads of unaffected parents. Parents with MS were identified using a validated algorithm, as those with ≥3 records related to MS in hospital admission, physician visit or prescription claims. Mental and physical morbidity in parents and children were also identified through a combination of hospital, physician and drug claims. In Manitoba, children in kindergarten with an MS parent were similar to matched children of unaffected parents on all developmental domains as assessed by the EDI. However, in the larger population-based cohort from British Columbia, children of mothers with MS had lower rates of vulnerability on the social competence domain (odds ratio 0.62, 95% confidence interval [CI] 0.44-0.87). Overall, mental health morbidity, such as anxiety and depression, was significantly more common among MS parents compared with MS-unaffected parents. Additionally, such parental mental health morbidity mediated the association between maternal MS and mood and/or anxiety disorders in children. Incidence rates of psychiatric disorders were significantly higher in children and adolescents with an MS parent who were exposed to parental MS since birth, compared with children and adolescents of MS-unaffected parents (hazard ratio 1.37, 95% CI 1.05-1.78). In summary, the presence of parental MS was not independently associated with adverse developmental health in kindergarten-aged children. However, MS was associated with substantially higher levels of mental health morbidity in parents and such morbidity was associated with adverse child and adolescent psychiatric morbidity.

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