Psychiatric disorders among children with cerebral palsy at school starting age

The aim of the present population study was to estimate the prevalence of psychiatric disorders in children with cerebral palsy (CP), as well as the impact of comorbid conditions. A cohort of children with CP born 2001–2003, and living in the Western Health Region of Norway were evaluated at school starting age. Parents were interviewed with the diagnostic instrument Kiddie-SADS, to find the prevalence of psychiatric disorders. Sixty-seven children participated, 43 boys, with mean age 88 months (SD 6,8 months). Most children had spastic CP, Gross Motor Function Classification System (GMFCS) levels I and II were found in 2/3 of the group. We found the diagnostic instrument appropriate for GMFCS levels I–IV. Child psychiatric disorders were found in 57% of the children, including 28 children meeting criteria for an attention deficit disorder, which was the most common. Communication problem was significantly associated with having a psychiatric disorder, whereas intellectual disability, type of CP and functional level did not account for significant differences. Subthreshold symptoms were found in 33 children, and 42 children (75%) met criteria for either psychiatric disorder, or mental health symptoms. One in four (14 children) were considered well-functioning from a mental health point of view. We conclude with a recommendation for early psychiatric evaluation of all children with CP.

► More than half of children with CP meet criteria for a child psychiatric diagnosis at school starting age, and an additional 20% are vulnerable for developing mental health disorders, of which attention problems are the most common. ► Communication problems are significant predictors for child psychiatric disorders. ► Focus on mental health issues in the follow-up programme for children with CP is recommended.