Daniel G. Whitney, PhD; Seth A. Warschausky, PhD; Sophia Ng, MPH, PhD; Edward A. Hurvitz, MD; Neil S. Kamdar, MA; Mark D. Peterson, PhD, MS
Acknowledgment: The authors thank Dr. Kevin Dombkowski for his expertise and guidance throughout this work.
Grant Support: From the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR 90RTHF0001-01-00).
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3420.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Reproducible Research Statement: Study protocol and data set: Not available. Statistical code: Available from Dr. Peterson (e-mail, email@example.com).
Corresponding Author: Mark D. Peterson, PhD, MS, Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, 325 East Eisenhower, Suite 300, Ann Arbor, MI 48108; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Whitney, Warschausky, and Peterson: University of Michigan, 325 East Eisenhower, Suite 300, Ann Arbor, MI 48108.
Dr. Ng and Mr. Kamdar: 2800 Plymouth Road, Ann Arbor, MI 48109.
Dr. Hurvitz: University of Michigan, 325 East Eisenhower, Suite 200, Ann Arbor, MI 48108.
Author Contributions: Conception and design: D.G. Whitney, E.A. Hurvitz, M.D. Peterson.
Analysis and interpretation of the data: D.G. Whitney, S.A. Warschausky, N.S. Kamdar, M.D. Peterson.
Drafting of the article: D.G. Whitney, S.A. Warschausky, N.S. Kamdar, M.D. Peterson.
Critical revision of the article for important intellectual content: D.G. Whitney, E.A. Hurvitz, M.D. Peterson.
Final approval of the article: D.G. Whitney, S.A. Warschausky, S. Ng, E.A. Hurvitz, N.S. Kamdar, M.D. Peterson.
Statistical expertise: N.S. Kamdar, M.D. Peterson.
Collection and assembly of data: D.G. Whitney, S. Ng.
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.
To determine the prevalence of mental health disorders among adults with CP compared with those without CP.
2016 Optum Clinformatics Data Mart.
8.7 million adults (including 7348 adults with CP).
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.
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.
Single claims code was used to define the cohort of interest. Information on the severity of CP was not available.
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.
National Institute on Disability, Independent Living, and Rehabilitation Research.
Whitney DG, Warschausky SA, Ng S, et al. Prevalence of Mental Health Disorders Among Adults With Cerebral Palsy: A Cross-sectional Analysis. Ann Intern Med. 2019;171:328–333. [Epub ahead of print 6 August 2019]. doi: https://doi.org/10.7326/M18-3420
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Published: Ann Intern Med. 2019;171(5):328-333.
Published at www.annals.org on 6 August 2019
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