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. 2025 Apr;56(2):299-311.
doi: 10.1007/s10578-023-01564-3. Epub 2023 Jun 26.

Longitudinal Association Between Youth Multimorbidity and Psychological Distress: Impact of the COVID-19 Pandemic

Mark A Ferro  1 , Alene Toulany  2   3
Affiliations

Longitudinal Association Between Youth Multimorbidity and Psychological Distress: Impact of the COVID-19 Pandemic

Mark A Ferro et al. Child Psychiatry Hum Dev. 2025 Apr.

Abstract

This research examined longitudinal associations between youth physical-mental multimorbidity and psychological distress before and during the COVID-19 pandemic; assessed the contextual impact of the pandemic on these associations; and, investigated potential moderating factors. The Multimorbidity in Youth across the Life-course, an ongoing study of youth aged 2-16 years (mean 9.4; 46.9% female) with physical illness, was used as the sampling frame for this COVID-19 sub-study, in which 147 parent-youth dyads participated. Psychological distress was measured using the Kessler-6 (K6). Multimorbidity was associated with higher pre-pandemic, but not with intra-pandemic distress. Disability moderated pre-pandemic distress-multimorbidity was associated with higher K6 among youth with high disability, but not among youth with low disability. Age moderated intra-pandemic distress-multimorbidity was associated with higher K6 in older youth, but not among younger youth.

Keywords: Adolescent; Child; Chronic disease; Comorbidity; Mental health; Physical illness; Psychiatric disorder.

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Conflict of interest statement

Declarations. Competing Interests: The authors have no relevant financial or non-financial interests to disclose. Ethics approval and consent to participate: Ethics approval for this study was obtained from the Waterloo Human Research Ethics Board (#31010) and Hamilton Integrated Research Ethics Board (#2797). Consent to Participate: Informed Consent was obtained from all individual participants included in this study. All participants 16 years and older provided informed consent, children 7–15 provided assent, and children 6 and younger were consented by their parents. Consent for publication: Not applicable.

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