A comparison of the emotional and behavioral problems of children of patients with cancer or a mental disorder and their association with parental quality of life Thomas Krattenmacher a, ⁎, Franziska Kühne a , Susanne Halverscheid a , Silke Wiegand-Grefe a , Corinna Bergelt b , Georg Romer a , Birgit Möller a a University Medical Center Hamburg-Eppendorf, Department of Child Adolescent Psychiatry, Psychotherapy and Psychosomatics, Germany b University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Germany abstract article info Article history: Received 6 June 2013 Received in revised form 28 November 2013 Accepted 29 November 2013 Keywords: Child care Coping Parents Cancer Oncology Psychosocial aspects Quality of life Objective: To compare the emotional and behavioral problems of children of patients suffering from cancer or a mental disorder and their association with parental quality of life. Methods: A total of 223 children from 136 families and their 160 parents were investigated from multiple perspectives in a cross-sectional study. The consistency of different adjustment reports between family members was examined. Through mixed models, the differences between parental HRQoL and the children's symptomatology were studied with regard to the type of parental illness. The prediction of children's adjustment through parental HRQoL was further examined. Additionally, gender and age of the children were considered. Results: Half of the children exhibited psychosocial problems. Gender and age differences were independent of the type of parental disease. In families with parental cancer, the reports of children's adjustment were more consistent between family members than in families where a parental mental disorder was present. We found differences in HRQoL between families with mentally ill parents and those with parental cancer patients. Specifically, the healthy partners of mentally ill parents showed worse HRQoL compared with healthy partners of cancer patients. Healthy parents' reduced HRQoL was associated with worse adjustment in their children, regardless of the type of parental illness, but this result was not found for ill parents. Conclusion: Family members confronted with parental cancer or mental disorders are more burdened compared with those from the “normal” population, independently of the type of disease. Our results indicate that the type of a parental disease has no direct effect on children's adjustment. However, there are disease-specific effects on parental HRQoL, which are associated with children's adjustment. © 2013 Elsevier Inc. All rights reserved. Introduction Children of parents with severe chronic illnesses or mental disorders are at an increased risk of developing psychosocial problems [1–4] with prevalence rates up to 23% [5]. Comparisons of families with physically ill parents indicate only marginal effects of different diagnoses on child psychosocial adjustment [2]. Likely, in the case of parental somatic diseases, illness-related factors are not directly associated with children's adjustment, but they could indirectly affect the children's environment. A recent systematic review of studies on parental cancer [6] summarized associated factors of children's psychosocial adjustment and found that most studies reported only minor associations with illness-related factors but stronger associations with family or individual characteristics. Studies on mentally ill parents indicate that differences in children's adjustment based on different psychiatric diagnoses could also be less related to the specific mental disorder itself and more related to various environmental factors [7]. In contrast to parental somatic diseases, parental mental disorders could also have a heritable effect on children's adjustment. Compared with parental somatic diseases, this could augment children's vulnerability and increase their risk for developing psychosocial problems [8–10]. Direct comparisons of different illness types are important to identi- fy their specific impact. Knowledge about common or different mecha- nisms of specific illness types enables the development of suitable psychosocial intervention programs for vulnerable populations. Never- theless, studies directly comparing families with physically ill parents and families with a parental mental disorder are rare. Anthony (1970) [11] examined families with mentally ill parents and families with par- ents who suffer from tuberculosis. In this study, families with parental mental disorders had a lower socioeconomic status, which is associated with worse adjustment in dependent children [12,13]. Another study [14] compared families with depressed mothers, mothers with other Journal of Psychosomatic Research 76 (2014) 213–220 ⁎ Corresponding author at: University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Martinistr, 52, D-20246 Hamburg, Germany. Tel.: +49 7410 57453; fax: +49 7410 55169. E-mail address: t.krattenmacher@uke.de (T. Krattenmacher). 0022-3999/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jpsychores.2013.11.020 Contents lists available at ScienceDirect Journal of Psychosomatic Research