Mental health disorders, participation, and bullying in children with cerebral palsy by Daniel G Whitney et al.

Aim: To examine how social factors might mitigate the elevated risk of mental health disorders in children with cerebral palsy (CP).

Method: This cross‐sectional study included 6‐ to 17‐year‐olds with (n=111; 40.4% 6–11y, 59.6% 12–17y) and without (n=29 909; 50.2% 6–11y, 49.8% 12–17y) CP from the 2016 National Survey of Children's Health. Mental health disorders included depression, anxiety, behavior/conduct problems, and attention‐deficit/hyperactivity disorder. Social factors included participation in activities, bully victimization, and difficulty with friendships. 

Results: After adjusting for sociodemographic factors and the presence of chronic pain, children with CP had higher odds of anxiety (odds ratio [OR] 4.4; 95% confidence interval [CI] 1.9–8.5), behavior/conduct problems (OR 3.9; 95% CI 1.4–11.3), and multimorbidity (OR 2.8; 95% CI 1.1–7.0), but not depression (OR 1.4; 95% CI 0.6–3.8) or attention‐deficit/hyperactivity disorder (OR 1.7; 95% CI 0.6–4.6), compared to controls. With adjustment for participation in activities, the odds of anxiety, behavior/conduct problems, and multimorbidity remained increased in children with CP. With adjustment for difficulty with friendships, the odds of anxiety, behavior/conduct problems, and multimorbidity were no longer increased in children with CP. With adjustment for bully victimization, the odds of behavior/conduct problems and multimorbidity were attenuated in children with CP; however, the odds of anxiety remained increased.

Interpretation: The elevated prevalence of certain mental health disorders in children with CP is partly associated with modifiable social factors.

What this paper adds:

  • Difficulty with friendships predicts an elevated prevalence of psychiatric conditions in children with cerebral palsy (CP).
  • Bully victimization predicts an elevated prevalence of behavior/conduct problems in children with CP.
  • Low participation does not predict mental health disorders in this population.

View the full paper


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