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Irrespective of their well-known increased risk for mental health problems, children of somatically ill parents are a clinically underserved as well as under-researched group. In this article, the authors introduce the epidemiologic and clinical relevance of this topic and present a theoretical framework for understanding the sequelae of a serious parental illness on minor-age children, based on family dynamics and developmental concepts. This is followed by a comprehensive review of current empirical studies in this field, with a special emphasis on results from a transnational European collaborative study (COSIP = Children of Somatically Ill Parents), which was coordinated by the last author. The most important recommendations from intervention concepts published to date are summarized. Some outlooks for clinical practice as well as future research are presented.
Mental Stress and Health-Related Quality of Life in Adolescents with Gender Dysphoria Although the level of mental stress in adolescents with gender dysphoria is found to be generally high in many studies, differences have been shown between samples of gender dysphoria clinics for adolescents in different countries. However, a comparison within the German speaking area is lacking. In this article we compared samples of gender dysphoria clinics from Munster (Germany) and Zurich (Switzerland) and tested potential correlates of mental stress using quantitative methods. Subsequently, we interviewed clients from both clinics regarding mental stressors and protective factors. There were no quantitative differences in the level of mental stress of clients between Munster and Zurich, whereas health-related quality of life was significantly higher in Munster. Problems in physical well-being and school environment were the strongest correlates of mental stress. This reflects in the interviews, too, in addition to further related factors reported. We conclude that physical well-being and inclusion at school should be addressed with special emphasis in counseling or treatment of adolescents with gender dysphoria to counter the in average high levels of mental stress. Zusammenfassung Das Ausmaß psychischer Auffälligkeiten bei Jugendlichen mit Geschlechtsdysphorie wird in vielen Studien als hoch beschrieben, unterscheidet sich jedoch in den Inanspruchnahmepopulationen verschiedener Spezialambulanzen für Jugendliche mit Geschlechtsdysphorie. Bislang hat kein Vergleich innerhalb des deutschsprachigen Raums stattgefunden. In diesem Beitrag werden die Inanspruchnahmestichproben der Spezialzentren in Münster und Zürich mit quantitativen Methoden verglichen sowie Korrelate von psychischen Auffälligkeiten geprüft. Anschließend führten wir Interviews mit Klient/innen1 der Spezialambulanzen hinsichtlich psychischer Belastungen und Schutzfaktoren durch. Es zeigten sich im quantitativen Vergleich der Zentren keine Unterschiede in den psychischen Auffälligkeiten zwischen Münster und Zürich, während sich die gesundheitsbezogene Lebensqualität in Münster als signifikant höher erwies als in Zürich. Als stärkste Korrelate psychischer Belastung konnten Probleme im körperlichen Wohlbefinden sowie im schulischen Umfeld identifiziert werden. Dies spiegelte sich auch in den qualitativen Interviews wider, in denen weitere assoziierte Faktoren benannt wurden. Wir schlussfolgern, dass das körperliche Wohlbefinden und die schulische Integration in der Beratung bzw. Behandlung von Jugendlichen mit Geschlechtsdysphorie besonders berücksichtigt werden sollten, um der im Schnitt hohen psychischen Auffälligkeiten entgegenzuwirken.
The purpose of this study was the analysis of psychological distress and health-related quality of life (HRQoL) of parents with minor children during curative resp. palliative treatment.Cross-sectional design with a sample of N=89 parent dyads. Dyadic analysis of demographic, illness and family variables via mixed linear models.Patients and healthy partners indicated psychological distress on different subscales. Intradyadic correlations were small-moderate. Most important predictors of psychological distress and HRQoL were treatment stadium, gender, family functioning, and employment status.Dependent on demographic variables, psychooncological support was evident mainly for parents in palliative care and for families with dysfunctional functioning.