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Published on: January 11, 2016
Mental health in children with cerebral palsy: does screening capture the complexity?
1Department of Paediatric Habilitation, Stavanger University Hospital, Stavanger, Norway. bjhm@sus.no
Insights
Children with cerebral palsy (CP) experience significantly more mental health issues than peers. While screening tools detect problems, they don't predict specific disorders in CP patients.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Developmental Psychology
Background:
- Cerebral palsy (CP) is a common childhood neurological disorder with frequent co-occurring medical and psychological symptoms.
- Assessing mental health in children with CP is crucial due to the high prevalence of associated conditions.
- Understanding the complexity of coexisting symptoms is vital for effective intervention.
Purpose of the Study:
- To compare mental health problems in children with CP to population controls.
- To evaluate the efficacy of a mental health screening tool (SDQ) in identifying psychiatric disorders in children with CP.
- To analyze the complexity and co-occurrence of mental health symptoms in this population.
Main Methods:
- A cohort of 47 children with CP was assessed using the Kiddie-SADS psychiatric diagnostic instrument and the Strengths and Difficulties Questionnaire (SDQ).
- A control group from the Bergen Child Study, a large epidemiological cohort, was used for comparison.
- Data were analyzed to compare problem scores and evaluate the screening tool's predictive accuracy.
Main Results:
- Children with CP exhibited significantly higher scores across all problem and impact measures compared to controls.
- Two-thirds of children with CP scored above the 90th percentile on the Total Difficulties Score (TDS).
- 57% of children with CP met criteria for a psychiatric disorder, with the SDQ showing 0.85 sensitivity and 0.55 specificity.
Conclusions:
- Children with CP have a high prevalence of mental health problems and symptom co-occurrence.
- The SDQ effectively screens for mental health issues but does not predict specific psychiatric disorders in children with CP.
- Integrated mental health services are recommended for children with CP due to symptom overlap and high prevalence, particularly for conditions like ADHD.
Introduction:
Children with cerebral palsy (CP), one of the most common childhood neurological disorders, often have associated medical and psychological symptoms. This study assesses mental health problems compared to population controls and the ability of a mental health screening tool to predict psychiatric disorders and to capture the complexity of coexisting symptoms.
Methods:
Children with CP (N = 47) were assessed according to DSM-IV criteria using a psychiatric diagnostic instrument (Kiddie-SADS) and a mental health screening questionnaire (SDQ). Participants from the Bergen Child Study, a large epidemiological study, served as controls.
Results:
Children with CP had significantly higher means on all problem scores including impact scores. Two in three children scored above 90th percentile cutoff on Total Difficulties Score (TDS), and 57% met criteria for a psychiatric disorder, yielding a sensitivity of 0.85 and a specificity of 0.55. Mental health problems coexisted across symptom scales, and peer problems were highly prevalent in all groups of psychiatric disorders.
Conclusion:
A high prevalence of mental health problems and co-occurrence of symptoms were found in children with CP compared to controls. Screening with SDQ detects mental health problems, but does not predict specific disorders in children with CP. ADHD is common, but difficult to diagnose due to complexity of symptoms. Mental health services integrated in regular followup of children with CP are recommended due to high prevalence and considerable overlap of mental health symptoms.
