Mental health disorders, participation, and bullying in children with cerebral palsy

Abstract

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.

Factors associated with depression and anxiety in children with intellectual disabilities

“…The prevalence of depression and anxiety problems in children with ID in the current study [15.4% (95% CI: 9.0–21.8) and 33.9% (95% CI: 24.8–43.1), respectively] was higher compared with children without ID or other disabilities from our previous study using the same dataset, variables and procedures [2.7% (95% CI: 2.4–3.1) and 6.2% (95% CI: 5.5–6.8)] (Whitney et al . ). Moreover, our prevalence estimates of depression and anxiety problems fall within the range reported in previous studies in children with ID that were examined in a recent meta‐analysis (Maiano et al .…”

A bio‐psycho‐social view of cerebral palsy: friendships reduce mental health disorders

“…Whitney et al. 's excellent study emphasizes child‐related (CP; bully victimization) and social factors (friendships; participation in activities). The considerably higher prevalence of psychological disturbance in children with CP is not inevitable.…”

“…‘Participation is not necessarily inclusion’ . Which environment is best for academic and social development?…”

“…'Participation is not necessarily inclusion'. 3 Which environment is best for academic and social development? Making inclusion successful during school years will probably come at a significant cost.…”

DMCN 2019 highlights: medical cannabis, developmental coordination disorder guidelines, cardiovascular disease in cerebral palsy, and more

“…Among hot topics in the 2019 volume, mental health in cerebral palsy (CP) was addressed by several studies, highlighting bullying and the emerging influence of social media, and emphasizing the need to identify protective factors for individuals with CP and their families . A clearer picture of cardiovascular risk, disease, and https://onlinelibrary.wiley.com/doi/10.1111/dmcn.14060 in adults with CP is also emerging thanks to a handful of papers whose conclusions invite readers to apply and evaluate proactive and preventive measures to optimize nutrition, sleep, and physical activity in these individuals …”