Living with pediatric multiple sclerosis: Patient well-being

The stress of having a chronic illness has countless effects on both a child or adolescent and his/her family, especially when there is uncertainty surrounding the prognosis of the illness, as is true of multiple sclerosis (MS) [1]. In general, lack of information and inadequate support hinder parents' efforts to cope with their child's disease [2,3]. The diagnosis of a chronic illness such as MS is confusing at any age but may be particularly challenging to older children, as the natural developmental instinct for children as they grow is to gain independence. These children are placed in a developmental bind where the dependence on others that is introduced by the illness conflicts with this natural drive for independence. Older children facing chronic illness are more likely to experience increased anxiety when their illness and its related issues, such as treatment, conflict with body image issues and desire for independence [4,5]. Since older children and adolescents are normally focused on the physical changes occurring in their bodies, fears or distortions related to chronic illness will intensify these concerns. In MS, for example, children may fear that their injection area will show and limit their ability to wear certain clothes. While the relationship between chronic illness and psychological adjustment is complicated and indirect, children with such illnesses are at risk for mental health and adjustment problems [6]. Depression and anxiety are more likely in children with chronic illness; these symptoms may be a primary feature or secondarily connected to the illness.