The Ontario Child Health Study: social adjustment and mental health of siblings of children with chronic health problems.

There has been controversy concerning the type and amount of psychosocial maladjustment among the siblings of children with chronic physical health problems and disabilities. Most previous studies have been conducted in clinical populations, often from tertiary care centers. This paper reports the risks of psychiatric disorders and social adjustment problems of the siblings of chronically ill children found in the Ontario Child Health Study (OCHS). The OCHS was a general population survey of 3,294 children, 4-16 years of age, living in 1,869 randomly selected families in the Province of Ontario, Canada. A 2-fold risk in emotional disorders, including depression, anxiety, and obsessive-compulsive disorder, and a 1.6-fold increase in risk in poor peer relationships were found. However, risks for conduct disorder, somatization disorder (measured only in 12- to 16-year olds), attention deficit disorder-hyperactivity, and one or more psychiatric disorders were not elevated. Moreover, no increased risks of adjustment problems, including social isolation, low participation in leisure activities, low competence in usual childhood recreational activities or school problems, were observed. Clinicians treating chronically ill children should assess the mental health and adjustment of their siblings without an expectation bias that problems will be found.