Prevalence of Mental Health Disorders Among Adults With Cerebral Palsy: A Cross-sectional Analysis

Ann Intern Med. 2019 Sep 3;171(5):328-333. doi: 10.7326/M18-3420. Epub 2019 Aug 6.

Abstract

Background: Persons with cerebral palsy (CP) have an increased risk for secondary chronic conditions during childhood, including mental health disorders. However, little is known about how these disorders affect adults with CP.

Objective: To determine the prevalence of mental health disorders among adults with CP compared with those without CP.

Design: Cross-sectional.

Setting: 2016 Optum Clinformatics Data Mart.

Patients: 8.7 million adults (including 7348 adults with CP).

Measurements: Other neurodevelopmental comorbid conditions (intellectual disabilities, autism spectrum disorders, epilepsy) and 37 mental health disorders (as 6 categories) were identified on the basis of diagnosis codes. Direct age-standardized prevalence of the mental health disorder categories was estimated by sex for adults with CP alone, adults with CP and neurodevelopmental disorders, and adults without CP.

Results: Men with CP alone had higher age-standardized prevalence than men without CP for schizophrenic disorders (2.8% [95% CI, 2.2% to 3.4%] vs. 0.7%), mood affective disorders (19.5% [CI, 18.0% to 21.0%] vs. 8.1%), anxiety disorders (19.5% [CI, 18.0% to 21.0%] vs. 11.1%), disorders of adult personality and behavior (1.2% [CI, 0.8% to 1.6%] vs. 0.3%), and alcohol- and opioid-related disorders (4.7% [CI, 3.9% to 5.5%] vs. 3.0%). The same pattern was observed for women. Compared with adults with CP alone, those with CP and neurodevelopmental disorders had similar or higher age-standardized prevalence of the 6 mental health disorder categories, except for the lower prevalence of alcohol- and opioid-related disorders in men.

Limitations: Single claims code was used to define the cohort of interest. Information on the severity of CP was not available.

Conclusion: Compared with adults without CP, those with CP have an elevated prevalence of mental health disorders, some of which may be more pronounced in patients with comorbid neurodevelopmental disorders.

Primary funding source: National Institute on Disability, Independent Living, and Rehabilitation Research.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cerebral Palsy / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Neurodevelopmental Disorders / epidemiology
  • Prevalence
  • Sex Distribution