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Psychiatric disorders after childhood stroke.
Jeffrey E Max1, Katherine Mathews, Amy E Lansing
1University of California, San Diego and Children's Hospital and Health Center, USA. jmax@ucsd.edu
Summary
Children with stroke have a higher rate of psychiatric disorders (PD) than those with orthopedic conditions. Neurological severity and family psychiatric history are key predictors of PD post-stroke.
Area of Science:
- Pediatric neurology
- Child and adolescent psychiatry
- Neuropsychology
Background:
- Psychiatric disorders (PD) are a significant concern in pediatric populations.
- Understanding the incidence and correlates of PD following acquired neurological conditions is crucial.
Purpose of the Study:
- To determine the rate, types, and correlates of psychiatric disorders (PD) in children and adolescents following stroke.
- To compare PD rates and associated factors between pediatric stroke and orthopedic disorder cohorts.
Main Methods:
- Cross-sectional study comparing 29 pediatric stroke subjects with 29 orthopedic subjects (ages 5-19).
- Comprehensive assessments included psychiatric status, cognitive, adaptive, academic, and family functioning, family psychiatric history, neuroimaging, and neurological status.
- Primary outcome was current PD not present before the index condition.
Main Results:
- Poststroke PD occurred significantly more often (59%) than post-orthopedic PD (14%).
- Children with poststroke PD showed more impaired intellectual/adaptive functioning and higher family psychiatric history scores.
- Neurological severity and family psychiatric history independently predicted PD in stroke survivors.
Conclusions:
- Pediatric stroke is associated with a high incidence of psychiatric disorders.
- Biopsychosocial factors, including neurological exam findings, lower IQ, and family psychopathology, are significant correlates of PD in children with focal neurological lesions.