Intended for healthcare professionals

Clinical Review ABC of adolescence

Chronic illness and disability

BMJ 2005; 330 doi: (Published 24 March 2005) Cite this as: BMJ 2005;330:721
  1. Michele Yeo,
  2. Susan Sawyer


Young people with chronic conditions often face more difficulties negotiating the tasks of adolescence than their healthy peers. National, population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months. However, 10-13% of teenagers report having a chronic condition that substantially limits their daily life or requires extended periods of care and supervision.

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Prevalence (per 1000 adolescents aged 12-18 years) of certain chronic conditions in mid-adolescence

The burden of chronic conditions in adolescence is increasing as larger numbers of chronically ill children survive beyond the age of 10. Over 85% of children with congenital or chronic conditions now survive into adolescence, and conditions once seen only in young children are now seen beyond childhood and adolescence. In addition, the prevalence of certain chronic illnesses in adolescence, such as diabetes (types 1 and 2) and asthma, has increased, as has survival from cancer.

Impact of chronic conditions on adolescence

Chronic conditions in adolescence can affect physical, cognitive, social, and emotional spheres of development for adolescents, with repercussions for siblings and parents too.

Growth chart (with 25th, 50th, 75th, and 91st centiles) of 13 year old girl with coeliac disease and anorexia nervosa. Coeliac disease was diagnosed at age 10 during investigation for short stature. She later presented, at age 13, with mother's concerns about restriction of food

Physical effects

Common sequelae of chronic illness and its treatment include short stature and pubertal delay. Undernutrition is common in many chronic conditions, and obesity can result from conditions that limit physical activity. Visible signs of illness or its treatment mark young people out as different at a time when such differences are important to young people and their peers. Body image issues related to height, weight, pubertal stage, and scarring can contribute to reduced self esteem and negative …

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