To the Editors,

Family is very important for development of children. Divorce is a life event with a high level of stress for the entire family. Children are dependent on parents and disadvantaged during divorce because it is out of their control.1 Herein, we present our observations about children whose parents separated or divorced to increase the awareness of physicians about the negative effects of divorce.

Individuals affected by parental divorce have a higher risk of developing a variety of mental health conditions including emotional and behavioral disorders, poor school performance, depression, anxiety, suicidal ideation, suicide attempt, distress, smoking and substance abuse.2,3 Externalizing problems in girls precede and predict later parental divorce. Post-divorce problems in children vary by raters, and may depend on the time lapse since divorce.4 Lansford et al 5 noted that early parental divorce/separation is more negatively related to trajectories of internalizing and externalizing problems than is later divorce/separation, whereas later divorce/separation is more negatively related to grades. In another study, divorce in parents was significantly associated with higher alcohol use disorder, higher cigarette dependence and higher water pipe dependence in adolescents.6 In the study of Tullius et al 7 the levels of both internalizing and externalizing problems were significantly higher in the period after parental divorce, but not in the period before divorce, with a persistent and increasing effect over the follow-up periods compared to adolescents not experiencing divorce. Zeratsion et al 8 reported that parental divorce in late adolescence does not lead to mental health problems, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce creates less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common. In our clinical practice, we have also observed various emotional, behavioral, psychosomatic, and conversion disorders in children, particularly in preadolescents and adolescents, before and/or after a separation or divorce of parents.

Children often lack information and skills to overcome the challenges that the divorce carries. Conflicting relationships between parents make up the biggest obstacle that makes it difficult for a child to successfully deal with changes in the family. Even though parents deal with heavy feelings, it is desirable to put them the child and his interests in the first place. In order to stabilize the family system, 2 to 4 years are usually needed.1 Physicians can assist families by providing support and advice, and advocating for children within systems that serve separating families. Physicians can provide information so that individuals who work with such children recognize, and are sensitive to, their individual needs, and provide supportive and nurturing experiences for the children in schools, camps and sporting activities. These efforts will promote better mental health outcomes for children affected by their parents’ separation.9 The most important way to minimize emotional harm to children involved in a separation and divorce is to ensure that children maintain a close and secure relationship with both parents, unless there is spousal or child abuse or neglect, or parental substance abuse.9 Age-appropriate explanation and counseling for the child and advice and guidance for the parents, as well as recommendation of reading material, may help reduce the potential negative effects of divorce. Often, referral to professionals with expertise in the social, emotional, and legal aspects of the separation and its aftermath may be helpful for these families.10 An example of paragraph from a reading material for parents is as follows: The most comprehensive centre of man’s worldly life, and its mainspring, and a paradise, refuge, and fortress of worldly happiness, is the life of the family. Everyone’s home is a small world for him/her. And the life and happiness of his/her home and family are possible through genuine, earnest, and loyal respect and true, tender, and self-sacrificing compassion. This true respect and genuine kindness may be achieved with the idea of the members of the family having an everlasting companionship and friendship and togetherness, and their parental, filial, brotherly, and friendly relations continuing for all eternity in a limitless life, and their believing this.11

In conclusion, we would like emphasize that various psychosocial, psychosomatic and conversion disorders may be seen in children affected by parental divorce. Physicians interested in child health can notice parents' separation problems during evaluation of children. Referral to professionals with expertise in separation may be helpful for conflicting parents.

Hüseyin Çaksen

Divisions of Pediatric Neurology and Genetics and Behavioral-Developmental Pediatrics, Department of Pediatrics, Necmettin Erbakan University, Meram Medical Faculty, Meram, Konya, Turkey
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.



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  11. Nursi BS. From the Risale-i Nur Collection. The Words. Söz, Istanbul 2012. The first part of an important supplement and addendum to the tenth word (cited 26 February 2021) Available from


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