Adults with cerebral palsy at increased risk for mental health disorders

1. In this cross-sectional study, adult patients with cerebral palsy (CP) had a higher prevalence of mental health disorders compared to adults without CP.

2. Some mental health disorders within the adult CP population may be more pronounced in patients with comorbid neurodevelopmental disorders.

Evidence Rating Level: 3 (Average)

Study Rundown: Cerebral palsy (CP) encompasses a variety of different movement disorders that vary in severity of motor impairment. Those affected by CP are at risk of different developmental comorbid conditions, such as communication impairment, and other secondary chronic conditions. While CP is the most common disability in childhood, the adult CP population is expanding due to increased survival rates. The purpose of this study was to identify the prevalence of mental health disorders in adults with CP compared to those without CP. It was found that adult CP patients were at higher risk for mental health disorders compared to adults without CP. This finding emphasized the need for further supports and screening among the adult CP population to help address the elevated proportion of mental health conditions. This study had several limitations. Of note, the information regarding the severity of CP was not available with respect to the claims-based data. Considering the heterogeneity of CP, these findings may not be applicable to all patients with CP of varying severity.

Click to read the study published today in Annals of Internal Medicine

Relevant Reading: The prevalence of mental health disorders and symptoms in children and adolescents with cerebral palsy: a systematic review and meta-analysis.

In-Depth [cross-sectional study]: A total of 8.7 million adults were included in this cross-sectional study to evaluate the prevalence of mental health disorders among adults with CP compared to those without CP. Data was extracted from the Optum Clinformatics Data Mart between January 1 to December 31 2016. Descriptive statistics were performed in the study, in addition to a sensitivity analysis. The main outcomes were direct age-standardized prevalence of mental health disorders and the prevalence of other neurodevelopmental comorbid conditions. Of the 8.7 million adults in the final study sample, the prevalence of CP was 0.84 per 1000 for the entire group. They observed a prevalence of 13.5% (95% CI, 12.7% to 14.3%) of neurodevelopmental conditions among the adults with CP compared to those without CP. Further, the age-standardized prevalence of mental health disorder categories stratified by group and sex showed that adults with CP had a higher prevalence of nearly all categories of mental health disorders. For example, among women, the prevalence of anxiety disorders in those with CP was 28.6% [CI, 26.8% to 30.4%] vs. 18.0% in those without CP. The authors also observed that those with CP and neurodevelopmental disorders had similar or higher age-standardized prevalence of many of the mental health disorder categories compared to adults with CP alone.

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