9 Child and adolescent psychiatry9.5 Physical health and psychiatric disorder
9.5.2 Interactions between physical and mental health in children
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Written by Resident Doctor Committee · Published
New in the 2027 syllabus
The College added this topic for exams from January 2027.
Effects in both directions
In children, physical and mental health affect each other in both directions.
Physical illness can change mood, anxiety, sleep, thinking (cognition), development and how much the child takes part in everyday life. The cause may be the illness itself, its treatment, or the changes it brings to daily life.
Psychiatric disorder can make it harder for a child to report symptoms, use treatment, eat well, stay active and engage with healthcare. In the other direction, worsening physical health can increase psychological distress.
Physical and psychiatric problems often occur together. Do not assume that one diagnosis explains every new symptom.
Type of interaction | What to look for in assessment |
|---|---|
Biological effects | Pain, inflammation, seizures, poor sleep or side effects of medicines |
Emotional meaning | Fear of procedures, a changed body image or losing independence |
Family response | More worry, conflict over treatment or difficulty letting the child become more independent |
Social disruption | Missing school, isolation and less contact with friends or activities |
Treatment burden | Complex routines that compete with the ordinary tasks of growing up |
Assessing difficulties with treatment
When a young person misses treatment, do not write it off as simple defiance. Explore:
what they understand about their illness and treatment
practical barriers
side effects
distress
the young person's own wishes.
If missing treatment is dangerous, assess for self-harm, eating-disorder behaviour, impaired decision-making and safeguarding concerns.
Responsibility for medicines and appointments shifts as the child develops. The move from parent-led care to self-management needs planning and support.
Integrated management
Joint goals cover physical safety and also what the child wants: their activities, relationships and emotional wellbeing.
Psychological care may focus on adjustment, anxiety, coping or a diagnosed disorder. It can run alongside ongoing medical investigation and treatment.
School adjustments keep the child in education and in contact with friends, within their health needs and what they can manage.
Family work helps communication and shared responsibility. It should not assume that the parents caused the illness.
Follow-up tracks both physical and psychological outcomes. A named clinician coordinates any concerns that cross service boundaries.