By Megan Brooks
NEW YORK—Adults with cerebral palsy (CP), with or without developmental disabilities, are much more likely to suffer a variety of mental health problems than their peers without CP, new research indicates.
"Many of these mental health disorders make living and enjoying life very difficult, especially if untreated or poorly managed," Dr. Daniel Whitney from University of Michigan told Reuters Health by email. "Therefore, clinicians treating adults with cerebral palsy should think about screening for mental health disorders and coordinating mental health services. This may go a long way in capturing mental health disorders to treat and/or manage early and appropriately as needed for the individual."
The authors of an editorial published with the study online today in Annals of Internal Medicine say the findings are "important to health professionals, policymakers, and researchers to understand, address, and potentially prevent mental health disorders within the context of promoting overall health."
CP is associated with an increased risk of secondary chronic conditions during childhood, including mental-health disorders, but little is known about how these disorders affect adults with CP.
Dr. Whitney and colleagues used an insurance claims database to gauge the prevalence of mental health disorders among adults with CP alone, adults with CP and a neurodevelopmental (ND) disorder, and adults without CP.
Among 8.7 million adults, 5,052 had CP alone and 2,296 had CP and ND disorder.
Men with CP alone had higher age-standardized prevalence than men without CP of schizophrenic disorders (2.8% vs. 0.7%), mood affective disorders (19.5% vs. 8.1%), anxiety disorders (19.5% vs. 11.1%), disorders of adult personality and behavior (1.2% vs. 0.3%), and alcohol- and opioid-related disorders (4.7% vs. 3.0%). The same pattern was observed for women.
Having CP plus another disability was associated with similar or higher rates of mental-health conditions, except for a lower prevalence of alcohol- and opioid-related disorders in men.
Dr. Gloria Krahn of Oregon State University, in Corvallis, and Dr. Susan Havercamp of Ohio State University, in Columbus, put the findings in context in their editorial.
Compared with adults without CP, those with CP have estimated rates "more than 5 times higher for psychotic disorders, 2 to 3 times higher for mood affective disorders, 1.5 to 2 times higher for anxiety disorders, and more than 3 times higher for disorders of adult personality and behavior," they point out.
"The health, both physical and mental, of persons with developmental disabilities is recently coming out of the shadows and gaining attention in research, policy, and practice," the editorial writers note.
But diagnosing and treating mental health conditions in people with developmental disabilities is "challenging," they write. "Limitations in their ability to self-report symptoms of mental distress may mean that health care needs are unrecognized and unmet."
Drs. Krahn and Havercamp say health professionals caring for adults with developmental disabilities "need to understand the social stressors they experience, differentiate mental health disorders from other contributors to behavioral problems, and participate in person-centered planning for the individual. Developing this expertise may require additional training."
SOURCE: http://bit.ly/2YJBABk and http://bit.ly/2YMdztl
Ann Intern Med 2019.
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