Breaking bad news: communication around parental multiple sclerosis with children

Families, Systems & Health, March, 2009 by Elena Paliokosta, Stavroula Diareme, Gerasimos Kolaitis, Emmanuel Tsalamanios, Spyros Ferentinos, Sofia Anasontzi, Eirini Lympinaki, Alkis Tsiantis, John Tsiantis, Clementine Karageorgiou, George Romer

CONCLUSIONS

Multiple sclerosis is an illness with varying clinical characteristics and unforeseen progress, an element related with considerable stress on the patients as well as their families. Families have to adjust constantly to the changes that the illness brings about and to reorganize everyday life respectively. Our findings imply that communication of the problem can be an important factor for the family well-being and adjustment, and families may be favored by professional support when they approach the difficult task of disclosure. Parents may need help to consider "how, what, and how much" they might talk to their children about parental illness and forthcoming changes in family life. In fact, they are likely to benefit from discussion even if they decide not to communicate any details to their children. The experience derived form the European multisided project 'Children of Somatically Ill Parents' (see Diareme et al., 2005) showed that parental illness is related to children's psychosocial problems and liaison psychological services for the family provided in the clinics treating the parental illness, may represent an option, as the context is familiar to the patients and available in critical periods of illness exacerbations (Diareme et al., 2007). Similar intervention programs have already been developed and implemented successfully for various psychosocial adversities, for example, terminal cancer (Christ, Siegel, Messagno, & Langosch, 1991). Further studies using more sophisticated measures are required to replicate present findings and provide more conclusive results in regards to the effect of different types and amount of communication of parental illness in family on child mental health.

ACKNOWLEDGMENTS

This study is part of an international multisite research project, which was supported by a grant from the European Union in its 5th Framework Program "Quality of Life" (QLGT--2001--02378): "Mental Health Prevention in a Target Group at Risk: Children of Somatically Ill Parents (COSIP)." The following institutions and Principal Investigators collaborated in this project:

1. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Germany (Dr. med. Georg Romer).

2. Department of Child and Adolescent Neuropsychiatry, University of Vienna (Prof. Dr. med. M. Friedrich).

3. Department of Psychology, University of Aarhus, Denmark (M. Thasturn, Ph.D).

4. Child Psychiatry Clinic, Turku University Hospital, Finland (Prof. Dr. J. Piha).

5. Department of Child Psychiatry, Athens University Medical School, "Aghia Sophia" Children's Hospital, Greece (Prof. J. Tsiantis).

6. Clinic of Child and Adolescent Psychiatry University of Medicine and Pharmacy, Bucharest, Romania (Prof. Dr. S. Milea).

7. Clinic of Child and Adolescent Psychiatry, Basle University Hospital, Switzerland (PD Dr. B. Steck).

8. Department of Psychological Medicine, Royal Marsden Hospital, Sutton, United Kingdom (M. Watson, Ph.D.).

REFERENCES