Chronic Physical Health Conditions and Emotional Problems From Early Adolescence Through Midadolescence

Published in: Academic Pediatrics [Epub February 2017]. doi:10.1016/j.acap.2017.02.002

by LaRita Jones, Sylvie Mrug, Marc N. Elliott, Sara L. Toomey, Susan R. Tortolero, Mark A. Schuster

Read More

Access further information on this document at Elsevier

This article was published outside of RAND. The full text of the article can be found at the link above.


Chronic physical health conditions are highly prevalent in youth, frequently persisting into adulthood and contributing to the current and future health care burden in the United States. Our study evaluated associations of chronic physical health conditions with depressive and physiological anxiety symptoms in a community sample of youth and examined how those associations changed from early to midadolescence.


In this longitudinal study of 5147 youth, students and their caregivers were interviewed when youth were in grades 5 (mean age=11), 7 (mean age=13), and 10 (mean age=16). Caregivers reported family sociodemographics, youth race/ethnicity, and youth chronic physical health history at baseline. Youth reported their depressive symptoms at each time point and their physiological anxiety symptoms at grades 7 and 10.


At age 11, 28.5% had experienced a chronic physical health condition. Having any chronic physical health condition was related to elevated depressive symptoms at age 11(2.05[plus or minus]0.05 vs 1.89[plus or minus]0.03; mean[plus or minus]standard error;P<.01)and anxiety symptoms at age 16 (2.72[plus or minus]0.06 vs 2.55[plus or minus]0.04;P<.05). Experiencing multiple conditions was also related to experiencing more depressive symptoms (b=0.13;P<.01)and physiological anxiety symptoms (b=0.13;P<.05). After adjusting for previous mental health symptoms, having any condition still predicted anxiety at age 16.


Children with chronic physical health conditions have an increased risk of depressive symptoms and physiological anxiety symptoms, especially in early and midadolescence. Repeated screening for these symptoms may help identify children in need of interventions.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.