In the Journals

Cerebral palsy tied to increased risk for mental health disorders

Adults with cerebral palsy, particularly those with neurodevelopmental disorders, have increased risk for mental health disorders compared with adults without cerebral palsy, according to a study published in the Annals of Internal Medicine.

“The adult [cerebral palsy (CP)] population is expanding because of increased survival rates and stable or marginally increased global prevalence of the condition during recent decades,” Daniel G. Whitney, PhD, of Michigan Medicine, the University of Michigan Depression Center and the Institute for Healthcare Policy and Innovation at the University of Michigan, and colleagues wrote.

“To date, there is a general lack of clinical awareness and resources for mental health disorders for persons with CP,” they continued.

Researchers reviewed a national database of insurance claims with more than79 million beneficiaries from 2001 to 2017. Data were used to identify adults with CP alone, adults with CP and a neurodevelopmental disorder and adults without CP who were enrolled for 12 months in 2016. The prevalence of 37 mental health conditions, divided into six categories, were included in the study.

After exclusions, 8.7 million adults made up the final sample, among whom 5,052 had CP and 2,296 had CP and a neurodevelopmental disorder. The prevalence of CP was 0.84 per 1,000 adults in the final sample.

In the study sample, adults with CP had a higher prevalence of mental health disorders compared with adults who did not have CP in all but one mental health category. The prevalence of behavioral syndromes tied to physiological disturbances and physical factors did not differ significantly between adults with and without CP.

Compared to those without CP, the age-standardized prevalence was higher in men with CP for schizophrenic disorders (2.8% vs. 0.7%), mood effective disorders (19.5% vs. 8.1%), anxiety disorders (19.5% vs. 11.1%), disorders of adult personality and behavior (1.2% vs. 0.3%), and alcohol and opioid-related disorders (4.7% vs. 3%). The rates were similar among women in the sample.

Adults with CP and neurodevelopmental disorders had similar rates of most mental health disorder categories but men had lower rates of alcohol and opioid-related disorders.

Whitney and colleagues noted that the results are critical, as mental health disorders are a significant contributor to disease burden that could be identified through clinical screening and linked to treatment.

In an editorial accompanying the study, Gloria Krahn, PhD, MPH, of Oregon State University and Susan Havercamp, PhD, of Ohio State University, explained that diagnosing and treating mental health conditions in those with developmental disabilities is challenging, and many physicians feel “unqualified and uncomfortable” treating these patients.

“Health professionals caring for adults with developmental disabilities need to understand the social stressors they experience, differentiate mental health disorders from other contributors to behavioral problems, and participate in person-centered planning for the individual,” they wrote, and noting that health care professionals may require additional training to meet the needs of those patients. – by Erin Michael

Disclosures: Havercamp, Krahn and Whitney report no relevant financial disclosures.

Adults with cerebral palsy, particularly those with neurodevelopmental disorders, have increased risk for mental health disorders compared with adults without cerebral palsy, according to a study published in the Annals of Internal Medicine.

“The adult [cerebral palsy (CP)] population is expanding because of increased survival rates and stable or marginally increased global prevalence of the condition during recent decades,” Daniel G. Whitney, PhD, of Michigan Medicine, the University of Michigan Depression Center and the Institute for Healthcare Policy and Innovation at the University of Michigan, and colleagues wrote.

“To date, there is a general lack of clinical awareness and resources for mental health disorders for persons with CP,” they continued.

Researchers reviewed a national database of insurance claims with more than79 million beneficiaries from 2001 to 2017. Data were used to identify adults with CP alone, adults with CP and a neurodevelopmental disorder and adults without CP who were enrolled for 12 months in 2016. The prevalence of 37 mental health conditions, divided into six categories, were included in the study.

After exclusions, 8.7 million adults made up the final sample, among whom 5,052 had CP and 2,296 had CP and a neurodevelopmental disorder. The prevalence of CP was 0.84 per 1,000 adults in the final sample.

In the study sample, adults with CP had a higher prevalence of mental health disorders compared with adults who did not have CP in all but one mental health category. The prevalence of behavioral syndromes tied to physiological disturbances and physical factors did not differ significantly between adults with and without CP.

Compared to those without CP, the age-standardized prevalence was higher in men with CP for schizophrenic disorders (2.8% vs. 0.7%), mood effective disorders (19.5% vs. 8.1%), anxiety disorders (19.5% vs. 11.1%), disorders of adult personality and behavior (1.2% vs. 0.3%), and alcohol and opioid-related disorders (4.7% vs. 3%). The rates were similar among women in the sample.

Adults with CP and neurodevelopmental disorders had similar rates of most mental health disorder categories but men had lower rates of alcohol and opioid-related disorders.

Whitney and colleagues noted that the results are critical, as mental health disorders are a significant contributor to disease burden that could be identified through clinical screening and linked to treatment.

In an editorial accompanying the study, Gloria Krahn, PhD, MPH, of Oregon State University and Susan Havercamp, PhD, of Ohio State University, explained that diagnosing and treating mental health conditions in those with developmental disabilities is challenging, and many physicians feel “unqualified and uncomfortable” treating these patients.

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“Health professionals caring for adults with developmental disabilities need to understand the social stressors they experience, differentiate mental health disorders from other contributors to behavioral problems, and participate in person-centered planning for the individual,” they wrote, and noting that health care professionals may require additional training to meet the needs of those patients. – by Erin Michael

Disclosures: Havercamp, Krahn and Whitney report no relevant financial disclosures.