Clinical Health Outcomes of Siblings of Children with Chronic Conditions: A Systematic Review and Meta-Analysis

Benjamin Martinez; Petros Pechlivanoglou; Dorisa Meng; Benjamin Traubici; Quenby Mahood; Daphne Korczak; Marlena Colasanto; Sanjay Mahant; Julia Orkin; Eyal Cohen

doi:10.1016/j.jpeds.2022.07.002

Clinical Health Outcomes of Siblings of Children with Chronic Conditions: A Systematic Review and Meta-Analysis

J Pediatr. 2022 Nov:250:83-92.e8. doi: 10.1016/j.jpeds.2022.07.002. Epub 2022 Jul 8.

Authors

Affiliations

¹ Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
³ Western University, London, Ontario, Canada.
⁴ Queen's University, Kingston, Ontario, Canada.
⁵ Hospital Library and Archives, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁶ Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada.
⁸ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
⁹ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: eyal.cohen@sickkids.ca.

PMID: 35810772
DOI: 10.1016/j.jpeds.2022.07.002

Abstract

Objective: The objective of the study was to assess clinical mental and physical health outcomes of siblings of children with chronic health condition(s) compared with siblings of healthy children or normative data.

Study design: We searched Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL through August 9, 2021. We included English-language studies that reported clinically diagnosable mental or physical health outcomes among siblings of children (<18 years old) with a chronic health condition, included a comparison group, and used an experimental or observational study design. Two reviewers extracted data and independently assessed risk of bias using the Newcastle Ottawa Scale.

Results: Of 9899 screened studies, 34 were included; 28 studies reported on mental health, 3 reported on physical health, and 3 reported on mortality. Siblings of children with chronic conditions had greater depression rating scale scores than their comparison groups (standardized mean difference = 0.53; 95% CI = 0.38-0.68; P < .001 [6 studies]), whereas anxiety scores were not substantially increased (standardized mean difference = 0.21; 95% CI = -0.02 to 0.43; P = .07 [7 studies]). The effects for confirmed psychiatric diagnoses (7 studies), mortality (3 studies), or physical health outcomes (3 studies) could not be meta-analyzed given the limited number of studies and between-study heterogeneity.

Conclusion: Siblings of children with chronic health conditions may be at an increased risk of depression. Our findings suggest the need for targeted interventions to support the psychological well-being of siblings of children with chronic health conditions.

Keywords: anxiety; chronic condition; depression; sibling.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Anxiety
Child
Chronic Disease
Depression*
Humans
Observational Studies as Topic
Outcome Assessment, Health Care
Siblings*

Grants and funding

FDN-143315/CIHR/Canada