CHRONIC ILLNESS PERCEPTION IN ADOLESCENCE - IMPLICATIONS FOR THE DOCTOR-PATIENT-RELATIONSHIP

Objective: To describe the inter-relationship of chronic illness sever ity as perceived by adolescents with both psychosocial well-being and objective measures of illness severity. Additionally to compare the ad olescents' perception of illness severity with how their physicians be lieve that the adolescents perceive their illness severity. Methods: T he psychological well-being of 48 adolescents with either cystic fibro sis (CF) or insulin-dependent diabetes mellitus (IDDM) was measured by four standardized questionnaires. The adolescents' perception of seve rity of illness was measured using an original instrument (PSCI), and this measure was compared to their physicians' estimates of how the ad olescents perceived the severity of their illness and clinical illness . Results: There were 24 patients in both the CF and IDDM groups. Both groups were found to function well psychosocially; although, there we re more patients with low self image compared to normative values. Dep ression and low self image were associated with a greater adolescent p erception of illness severity. For both chronic illness groups, physic ians' assessment of assumed adolescent perception of disease severity correlated with clinical indices of disease severity and was higher th an the perception of illness severity reported by the adolescents. For adolescents with CF, but not with IDDM, perception of severity of chr onic illness correlated with clinical indices. Conclusions: For adoles cents with chronic illness, their perception of illness severity is an important indicator of psychosocial well-being. Physicians do not acc urately infer their patients' perception of illness severity.