Children with cerebral palsy (CP) have an elevated risk of developing mental health disorders, which is partially accounted for by their levels of pain, physical activity, and sleep, according to a study.
The study, “Mental health disorders and physical risk factors in children with cerebral palsy: a cross-sectional study,” was published in the journal Developmental Medicine & Child Neurology.
Cerebral palsy patients are at a higher risk of developing mental health disorders due to the various social and physical limitations of the disease. However, information is lacking about the occurrence of mental health disorders in children with cerebral palsy.
In a cross-sectional study, researchers at the University of Michigan assessed physical activity, sleep duration, and pain in children with and without cerebral palsy, and associated the data with the prevalence of mental health disorders.
The study included 111 children from 6 to 17 years of age with cerebral palsy and 29,909 children without the disorder from the 2016 National Survey of Children’s Health (NSCH). The NSCH collects state and nationwide data on the mental and physical health of American children younger than 18.
Anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), attention deficit disorder, and behavioral/conduct problems were considered mental health disorders. Physical risk factors included physical activity (number of days that the child exercised, played a sport, or participated in physical activity for at least 60 minutes), sleep duration, and pain.
Statistical analysis was used to compare the mental health status between children with and without cerebral palsy, adjusting for factors such as age, sex, ethnic group, and socioeconomic status — all of which could bias the comparison.
The study found that the odds of having a mental health disorder — except for attention deficit disorder/ADHD — were higher in children with cerebral palsy compared with those without the disorder. The likelihood of anxiety and behavior/conduct problems was 3.8 times higher in children with cerebral palsy.
Children with cerebral palsy had a significant lack of physical activity compared with children without the disorder, and a higher prevalence of pain (39%) than the control group (7.6%). Additionally, 65.9% of children without cerebral palsy slept for the recommended age-appropriate hours compared with 56.4% of those with cerebral palsy.
The odds of depression in cerebral palsy children were higher than in children without the disorder. However, when physical activity, sleep and pain were factored into the statistical analysis, the odds of depression were no longer different between the two groups, but the odds of anxiety and behavior/conduct problems remained significantly higher in children with cerebral palsy.
“Children with CP have an elevated prevalence of mental health disorders even after accounting for physical risk factors,” the researchers wrote. “Physical activity and pain accounted, at least in part, for the association between CP and depression and accounted for a portion of the association between CP and other mental health disorders.”
Further studies are needed to test the effects of improving physical health and lowering pain levels on the mental health status of cerebral palsy patients, the team concluded.