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Mental health disorders and physical risk factors in children with cerebral palsy: a cross‐sectional study
Author(s) -
Whitney Daniel G,
Warschausky Seth A,
Peterson Mark D
Publication year - 2019
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14083
Subject(s) - odds ratio , anxiety , cerebral palsy , depression (economics) , medicine , cross sectional study , mental health , psychiatry , confidence interval , population , attention deficit hyperactivity disorder , odds , pediatrics , physical therapy , logistic regression , pathology , environmental health , economics , macroeconomics
Aim To examine the prevalence of mental health disorders among children with and without cerebral palsy ( CP ), and to examine how physical risk factors in children with CP might mitigate any elevated risk of mental health disorders in this population. Method Children from 6 years to 17 years of age with ( n =111) and without ( n =29 909) CP from the 2016 National Survey of Children's Health were included in this cross‐sectional study. Mental health disorders included depression, anxiety, behavior/conduct problems, and attention deficit disorder/attention‐deficit/hyperactivity disorder ( ADHD ). Physical risk factors included physical activity (number of active days ≥60min), sleep duration, and pain. Results Adjusting for sociodemographics, children with CP had higher odds of mental health disorders (odds ratio [ OR ]=2.7–7.1, p <0.05) except for attention deficit disorder/ ADHD ( OR =2.5; 95% confidence interval [ CI ]=0.9–7.1). Further adjusting for physical factors, the odds of depression were no longer increased (i.e. attenuated) in children with CP ( OR =1.0; 95% CI =0.3–3.3); however, the odds of anxiety ( OR =3.8; 95% CI =1.9–7.8) and behavior/conduct problems ( OR =3.8; 95% CI =1.3–11.1) remained elevated. Assessed individually, low physical activity and pain attenuated the odds of depression in children with CP ( OR =1.9; 95% CI =0.7–5.3; OR =1.4; 95% CI =0.6–3.8 respectively). Interpretation Children with CP have an elevated prevalence of mental health disorders even after accounting for physical risk factors. Low physical activity and pain partially accounts for the association between CP and depression. What this paper adds Children with cerebral palsy (CP) have an elevated risk of developing mental health disorders. Physical factors do not fully account for higher mental health disorder prevalence. Physical activity partially accounts for the relationship between CP and depression. Pain partially accounts for the relationship between CP and depression.