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Psychological morbidity among adults with cerebral palsy and spina bifida

Published online by Cambridge University Press:  27 July 2020

Mark D. Peterson Open the ORCID record for Mark D. Peterson [Opens in a new window] ,
Paul Lin ,
Neil Kamdar ,
Elham Mahmoudi ,
Christina N. Marsack-Topolewski ,
Heidi Haapala ,
Karin Muraszko  and
Edward A. Hurvitz
Mark D. Peterson*
Affiliation:
Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Paul Lin
Affiliation:
Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Neil Kamdar
Affiliation:
Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Department of Obstetrics and Gynecology, Michigan Medicine, University of MichiganAnn Arbor, MI, USA Department of Emergency Medicine, Michigan Medicine, University of MichiganAnn Arbor, MI, USA Department of Surgery, Michigan Medicine, University of MichiganAnn Arbor, MI, USA
Elham Mahmoudi
Affiliation:
Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Department of Family Medicine, Michigan Medicine, University of MichiganAnn Arbor, MI, USA
Christina N. Marsack-Topolewski
Affiliation:
School of Social Work, Eastern Michigan University, Ypsilanti, MI, USA
Heidi Haapala
Affiliation:
Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Karin Muraszko
Affiliation:
Department of Neurosurgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Edward A. Hurvitz
Affiliation:
Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
*
Author for correspondence: Mark D. Peterson, E-mail: mdpeterz@med.umich.edu
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Abstract

Background

Very little is known about the risk of developing psychological morbidities among adults living with cerebral palsy (CP) or spina bifida (SB). The objective of this study was to compare the incidence of and adjusted hazards for psychological morbidities among adults with and without CP or SB.

Methods

Privately insured beneficiaries were included if they had an International Classification of Diseases, Ninth revision, Clinical Modification diagnostic code for CP or SB (n = 15 302). Adults without CP or SB were also included (n = 1 935 480). Incidence estimates of common psychological morbidities were compared at 4-years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident psychological morbidities.

Results

Adults living with CP or SB had a higher 4-year incidence of any psychological morbidity (38.8% v. 24.2%) as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Fully adjusted survival models demonstrated that adults with CP or SB had a greater hazard for any psychological morbidity [hazard ratio (HR): 1.60; 95% CI 1.55–1.65], and all but one psychological disorder (alcohol-related disorders), and ranged from HR: 1.32 (1.23, 1.42) for substance disorders, to HR: 4.12 (3.24, 5.25) for impulse control disorders.

Conclusions

Adults with CP or SB have a significantly higher incidence of and risk for common psychological morbidities, as compared to adults without CP or SB. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce the risk of disease onset/progression in these higher-risk populations.

Keywords

Anxietycerebral palsydepressiondisabilityspina bifida
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 4 , March 2021 , pp. 694 - 701
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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