A new study, published in Annals of Internal Medicine, highlights the need for increased awareness of mental health disorders among adults with cerebral palsy.
“According to the Centers for Disease Control and Prevention, 1 in every 323 children in the United States has been identified as having cerebral palsy,” says Daniel Whitney, Ph.D., an assistant professor of physical medicine and rehabilitation at Michigan Medicine.
“Much of the research regarding cerebral palsy focuses on childhood.
However, with modern treatment advances, many of these children grow up to be adults,” says Whitney, the study’s lead author.
“Unfortunately, far less is known about the health and clinical care needed to promote healthy aging throughout the adult lifespan for this patient population.”
Mark Peterson, Ph.D., M.S., FACSM, an associate professor of physical medicine and rehabilitation at Michigan Medicine and the senior author of the study, adds, “For example, how is this patient group’s overall health and quality of life in adulthood?
There isn’t much research available to help answer this question and others.”
In the study, Whitney and Peterson focus on mental health in adults with cerebral palsy and find that the patient population experiences an elevated prevalence of mental health disorders.
“And some of these mental health disorders were more pronounced in patients with cerebral palsy that also have comorbid neurodevelopmental disorders, such as intellectual disabilities, autism or epilepsy,” Peterson says.
“Which makes sense, as patients with cerebral palsy have an increased risk for secondary chronic conditions during childhood.”
Examining data
Whitney and Peterson, both members of the University of Michigan Institute for Healthcare Policy and Innovation, examined insurance claims data for adults, both with cerebral palsy and those without the condition, and if the individual had a mental health disorder.
“We found that adults with cerebral palsy had higher age-standardized prevalence of mental health disorders compared to adults without cerebral palsy,” Whitney says.
More specifically, the research team found male adults with cerebral palsy had higher prevalence of schizophrenic disorders (2.8% vs. 0.7%), mood affective disorders (19.5% vs. 8.1%), anxiety disorders (19.5% vs. 11.1%) and disorders of adult personality and behavior (1.2% vs. 0.3%), compared to their male adult counterparts.
“Female patients with cerebral palsy also exhibited similar or higher prevalence of those mental health disorders versus their female counterparts,” Peterson says.
The research team did find one exception.
“We found that adult males with cerebral palsy exhibited higher rates of alcohol and/or opioid-related disorders compared to their male counterparts, whereas women with cerebral palsy did not exhibit higher rates of these disorders compared to their female counterparts,” Peterson says.
Future implications
Whitney and Peterson agree that the results of this study demonstrate the need for additional focus on the mental health care of adults with cerebral palsy.
“Clinicians caring for adults with cerebral palsy need to be aware of the increased prevalence of mental health disorders in this patient population,” Peterson says.
Whitney agrees, “We hope this study highlights the need for improved mental health screenings and access to mental health services and resources for these patients.”
Cerebral palsy (CP) is a group of nervous system disorders that cause muscle coordination problems and other movement issues. It may be caused by injury or infection during pregnancy or during or after birth. It may also be the result of genetic mutations.
No matter the cause, CP occurs early in life. Symptoms often show up in the first years of a child’s life.
There is no condition known as late-onset CP. You can’t develop this condition as an adult. Plus, CP is non-progressive. That means it doesn’t worsen over a person’s lifetime. However, as a person living with CP ages, the condition can cause new challenges and issues.
Read on to learn more about life as an adult with CP and how you can prepare for new challenges.
Symptoms of CP in adults
The symptoms adults with CP experience often depend on the type of CP they have, as well as the level.
Some forms of CP, such as spastic cerebral palsy, cause stiff muscles, exaggerated reflexes, and abnormal movements when walking or trying to move. CP can affect the entire body, but it may also only impact one side of it.
Common symptoms of CP include:
- muscle weakness
- stiff muscles
- scissor-like movements with legs when walking
- paralysis
- involuntary movements in hands, arms, and legs
- twitching of the face and tongue
- difficulty swallowing
- loss of muscle tone
- floppy limbs that move easily
Premature aging, as well as more pronounced mental and physical impairments, may make it seem as if CP is worsening with age. It’s not. It’s a non-progressive condition.
Instead, the condition can slowly compromise the body’s ability to move and work effectively, which may feel as if the condition is worsening.
It’s important to keep in mind that symptoms of CP will not show up for the first time in adults. If you or a loved one are experiencing new issues with movement, it’s likely a result of another condition, not CP.
Common mental health concerns
People living with CP may feel isolated because of the condition. You may avoid events or outings. You may be afraid to feel ashamed or embarrassed because of physical limitations. This can lead to social isolation, anxiety, and even depression.
Depression is more commonTrusted Source in individuals with chronic diseases like CP. In fact, one 2017 study of 501 adults with CP found that 20 percent of them had depression.
This same study found that depression was more common in those who also had gastrointestinal conditions or used oral painkillers.
Mental health issues may be overlooked because CP is primarily a physical condition. The focus for treatment may be on improving mobility, decreasing pain, and prolonging energy. However, the effects of depression and mental health issues can increase the severity of CP.
It’s important that you and your doctor address your emotional and mental needs, as well as your physical ones. Support groups, therapists, and other mental health experts can be a good resource for individuals with CP.
People with CP have higher ratesTrusted Source of:
- hypertension
- heart conditions
- diabetes
- urinary incontinence
- asthma
- joint pain
- arthritis
- swallowing difficulties
- hearing impairments
- stroke
- emphysema
- scoliosis
- speech difficulties
The combination of CP symptoms and these other medical conditions can impact a person’s general well-being and health. It may make symptoms of either condition worse, too. Fortunately, there are treatments for many of these conditions.
More information: Daniel G. Whitney et al, Prevalence of Mental Health Disorders Among Adults With Cerebral Palsy, Annals of Internal Medicine(2019). DOI: 10.7326/M18-3420
Journal information: Annals of Internal Medicine
Provided by University of Michigan
