Health-related quality of life in children and adolescent with ASD: the role of mothers' emotional symptoms

Objective: Health-related quality of life (HRQOL) in children with autism spectrum disorder (ASD) has been the subjects of many studies. However, there is limited literature about the effects of parental mental health problems on the HRQOL of children with ASD. This study aims to compare HRQOL of ASD children and their mothers' emotional problems with healthy controls and to investigate the associations between ASD children's HRQOL and maternal psychiatric symptoms. Methods: The sample consisted of 81 ASD patients and 79 healthy controls, with an age range of 2-18 years, and an equal number of mothers. Childhood Autism Rating Scale was used to check severity of autistic symptoms, Kinder Lebensqualitatsfragebogen: Children's Quality of Life Questionnaire-revised (KINDL-R) was used to examine child HRQOL, Beck Depression Inventory (BDI) was used to evaluate maternal depressive symptoms, and State-Trait Anxiety Inventory (S-STAI, T-STAI) was used to assess maternal anxiety symptoms. Results: BDI and T-STAI total scores were significantly higher, KINDL-R total score, physical well-being, family, social, and school subscores were significantly lower in children with ASD than the control group. BDI total score was significantly higher, self-esteem and social subscores of KINDL-R were significantly lower in the severe ASD group. Self-esteem and school subscores of KINDL-R were significantly lower in ASD children with clinically anxious mothers. Among ASD children, family and school subscores of KINDL-R were negatively correlated with BDI total score. Conclusions: ASD patients have lower HRQOL than typically developing peers. Mothers of ASD children experience greater anxiety and depressive symptoms. Self-esteem and school performance in ASD children appear to be linked with maternal anxiety symptoms. Family and school problems in ASD children may be associated with maternal depressive symptoms.