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Abstract
Objective To determine individual and aggregated associations of cerebral palsy (CP)-related symptoms and the effect of comorbid neurodevelopmental conditions on mood (affective) disorders among adults with CP.
Methods Cross-sectional data from 2016 were extracted from a random 20% sample of the Medicare fee-for-service database. International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes were used to identify 18- to –64-year-old beneficiaries with CP, as well as mood (affective) disorders, pain, sleep disorders, fatigue, and comorbid neurodevelopmental conditions (intellectual disabilities [ID], autism spectrum disorders [ASD], and epilepsy).
Results Four thousand eight hundred twenty-three of the 17,212 adults with CP had mood (affective) disorders (28.0%). After adjusting for age, sex, and race, pain (odds ratio [OR] = 2.15; 99.5% confidence interval [CI] = 1.94–2.39), sleep disorders (OR = 2.43; 99.5% CI = 2.13–2.77), fatigue (OR = 1.38; 99.5% CI = 1.18–1.60), ID (OR = 1.47; 99.5% CI = 1.31–1.63), ASD (OR = 1.44; 99.5% CI = 1.16–1.80), and epilepsy (OR = 0.81; 99.5% CI = 0.73–0.91) were each associated with mood (affective) disorders. When pain, sleep disorders, and fatigue were presented as a count variable, the adjusted odds of mood (affective) disorders increased with the number of factors: 1 factor (OR = 1.99; 99.5% CI = 1.79–2.22), 2 factors (OR = 4.18; 99.5% CI = 3.58–4.89), and all 3 factors (OR = 7.38; 99.5% CI = 5.17–10.53).
Conclusions Among young and middle-aged adults with CP, mood (affective) disorders were associated with pain, sleep disorders, and fatigue, and increasing co-occurrence of these factors further increased the likelihood of mood (affective) disorders. Further, comorbid neurodevelopmental conditions were also associated with mood (affective) disorders among adults with CP. Study findings could be used to improve screening strategies for mood (affective) disorders among adults with CP in the clinical setting.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- Received March 20, 2019.
- Accepted June 25, 2019.
- © 2019 American Academy of Neurology
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