Risk of Depression and Anxiety in Adults With Cerebral Palsy

Smith, Kimberley J.; Peterson, Mark D.; O’Connell, Neil E; Chapot, Victor; Liverani, Silvia; Anokye, Nana; Ryan, Jennifer M

doi:10.1001/jamaneurol.2018.4147

Cited by 120 publications

(126 citation statements)

References 49 publications

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“…In the current study, we found that adults with CP had higher adjusted odds of pain, osteoarthritis, depressive disorders, and anxiety disorders, which is consistent with previous studies. 5,9,10 Pediatric chronic pain is associated with increased risk for lifetime depressive and anxiety disorders. 41 Further, osteoarthritis may exacerbate pain, which can negatively affect function and activities of daily living, 42 thus posing another mechanism for adverse mental health processes and low social participation.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Consequently, adults with CP are at risk of early development of several medical conditions that incur excess health care costs and represent a considerable patient and caregiver burden, including chronic pain, 11 heightened fracture susceptibility, 8 and non-communicable diseases (eg, cardiometabolic, mental health). 9,10,12,13 There is very little knowledge about the life-course health development and healthy aging process among adults with CP, resulting in insufficient clinical care for these populations. At present, the US health care system is not well-designed to meet the greater demands imposed by individuals with neurological conditions, 14,15 thus further increasing risk of health disparities that may otherwise be prevented or lessened.…”

Section: Introductionmentioning

confidence: 99%

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<p>Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy</p>

Whitney

Kamdar²,

Ng³

et al. 2019

CLEP

132

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Purpose: Individuals with cerebral palsy (CP) are susceptible to early development of highburden medical conditions, which may place a considerable strain on health care resources. However, little is known about the prevalence of high-burden medical conditions or health care resource utilization among adults with CP. The purpose of this study was to determine the prevalence of high-burden medical conditions and health care resource utilization and costs among adults with CP, as compared to adults without CP. Patients and methods: Cross-sectional data from the 2016 Optum Clinformatics ® Data Mart, a de-identified nationwide claims database of beneficiaries from a single private payer in the US. ICD-10-CM diagnosis codes were used to identify all medical conditions among beneficiaries with and without CP who were between 18 and 64 years of age. Medical and outpatient pharmacy claims were used to identify annual all-cause health care resource utilization and health care costs as standardized reimbursement and patient out-of-pocket costs. Results: Adults with CP (n=5,555) had higher prevalence and odds of all medical conditions compared to adults without CP (OR=1.3-5.8; all P<0.05), except cancer (OR=1.1; 95% CI=0.9-1.3). Adults with CP had greater annual mean counts of all health care service types (eg, inpatient, emergency department) compared to adults without CP (all P<0.01). Adults with CP had higher unadjusted standardized reimbursement (mean difference=$16,288; cost ratio [CR]=3.0; 95% CI=2.9-3.1) and patient out-of-pocket (mean difference=$778; CR=1.7; 95% CI=1.6-1.7) costs compared to adults without CP. After adjusting for all prevalent medical conditions, adults with CP still had higher standardized reimbursement (CR=2.5; 95% CI=2.5-2.6) and patient out-of-pocket (CR=1.8; 95% CI=1.7-1.8) costs. Conclusion: Adults with CP have a higher prevalence of high-burden medical conditions, health care resource utilization, and health care costs compared to adults without CP. Study findings suggest the need for earlier screening strategies and preventive medical services to quell the disease and economic burden attributable to adults with CP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy</p>

Whitney

Kamdar²,

Ng³

et al. 2019

CLEP

132

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“…Evidence suggests that the prevalence of obesity-related noncommunicable diseases and mortality are higher for adults with CP than the general population. 22,28,30 Since many chronic disease processes initiate in childhood, this systematic scoping review highlights the need for further clinical and translational research regarding body fat assessment and biology, because of its potential impact on growth, function and health among children and young people with CP.…”

Section: Discussionmentioning

confidence: 99%

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

et al. 2019

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Summary The purpose of our scoping review was to determine if children and young people with cerebral palsy (CP) have elevated total or regional body fat compared to children and young people without CP. Databases (Ovid MEDLINE, Embase Ovid, CINHAL and Scopus) were systematically searched from 1 January 1993 to 7 December 2018 in order to identify articles that compared weight status, total body fat or regional body fat (eg, abdominal) between children and young people (0‐21 years) with and without CP. Extracted data included country, subject characteristics, group sample sizes and matching strategies, methods/measures for weight status/fat depot, fat depot(s) assessed and key findings. Twenty‐two studies were included. Of these, 19 studies examined total body fat; the most common method was use of anthropometrics and the more common measures were body mass index and skin‐fold thickness. Twelve studies examined at least one regional fat depot; the most common method was use of anthropometrics and the most common measure was skin‐fold thickness. Findings were inconsistent across studies. Further, among 10 studies that examined total and regional body fat depots, 8 found differences across fat depots within the same children and young people (eg, no difference in total body fat but higher abdominal fat). This review provides a summary of inconsistent findings from published studies on body fat comparisons between children and young people with vs without CP, highlights limitations for evaluating body fat for children with CP and discusses future research directions.

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“…It is also important to note that OA is implicated in the pathogenesis of cardiometabolic diseases (37) and mental health disorders (38) among adults without CP. Adults with CP have elevated cardiometabolic disease prevalence (9), higher incidence of depression and anxiety (39), and 2-3-fold increased risk of cardiovascular mortality (40) compared with adults without CP. While it is unknown how OA associates with non-communicable diseases and mortality among adults with CP, OA has been shown to amplify daily pain levels and negatively affect function and activities of daily living for adults without CP (1).…”

Section: Discussionmentioning

confidence: 99%

Increased prevalence of osteoarthritis in adults with cerebral palsy

French¹,

Torres²,

Whitney³

2019

J Rehabil Med

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The aim of this study was to compare the prevalence of osteoarthritis between adults with and without cerebral palsy. Data were collected from the 2016 Optum Clinformatics® Data Mart, a nationwide de-identified US insurance claims database, containing medical and pharmacy information on beneficiaries. International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (age 18+ years) with and without cerebral palsy. ICD-10 codes were also used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with (n = 7,348) and without (n = 8.7 million) cerebral palsy, before and after adjusting for age and sex. The results showed that adults with cerebral palsy had a higher prevalence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis. Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with men and women without cerebral palsy across all age groups. Adults with cerebral palsy had a higher prevalence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan. Objective: Adults with cerebral palsy have an increased risk of developing osteoarthritis. However, little is known about the epidemiology of osteoarthritis among this vulnerable population. The objectives of this study were to compare the prevalence of osteoarthritis between adults with and without cerebral palsy, and to determine how the prevalence of osteoarthritis changes throughout adulthood for each group. Design: Data were extracted from the 2016 Optum Clinformatics® Data Mart, a nationwide database of de-identified US insurance claims, containing medical and pharmacy information on beneficiaries. Subjects: International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (18+ years) with (n = 7,348) and without (n = 8.7 million) cerebral palsy. Methods: ICD-10 codes were used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with and without cerebral palsy before and after adjusting for age and sex. The prevalence of any type of osteoarthritis was compared between men and women with and without cerebral palsy, stratified by the following age groups: 18-30, 31-40, 41-50, 51-60, 61-70, and > 70 years. Results: Adults with cerebral palsy had higher prevalence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis (odds ratio (OR): 1.3-2.1; p < 0.001), but not hand osteoarthritis (OR: 0.86; p = 0.46). Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with adults without cerebral palsy across all age groups (all p < 0.05). Conclusion: Privately-insured adults with cerebral palsy had a higher prevalence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan.

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Risk of Depression and Anxiety in Adults With Cerebral Palsy

Abstract: This cohort study assesses depression and anxiety in adults with cerebral palsy compared with age-, sex-, and practice-matched adults with cerebral palsy.

Cited by 120 publications

References 49 publications

<p>Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy</p>

<p>Prevalence of high-burden medical conditions and health care resource utilization and costs among adults with cerebral palsy</p>

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

Increased prevalence of osteoarthritis in adults with cerebral palsy

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