Abstract
Chronic handicap in early life may have a long-term impact on children’s psychosocial well-being. Here, we investigated whether Brachialis Plexus Birth Injury (BPBI)—an unpredictable injury at birth—is associated with worse mental health later on, as indicated by prescription and use of psychotropic drugs in adolescence. We explored further whether this association is different depending on socioeconomic characteristics of the child’s family, as well as sex. Of the 641 151 children born to native parents in Sweden 1987–1993 (alive and still living in Sweden at the end of 2008), identified in the Swedish Medical Birth Registry, 1587 had suffered a BPBI. Logistic regression analysis was performed to assess the impact of socioeconomic characteristics and associations with later psychosocial health. Results show that beyond the known increased risks for females as compared to males, BPBI, but also lower family income, further increased the risk of burdened mental health requiring psychotropic drug use in adolescence. The effects were additive. Thus, compared to unaffected peers, teenagers who suffered a BPBI at birth are at higher risk of suffering poor mental health during adolescence, independently of surgical intervention and its outcome. Girls growing up in families with lower socioeconomic status have this risk added to their already increased risk of poor mental health during adolescence.
Highlights
Child chronic illness may cause deep, long-lasting crisis in affected families [1,2,3]
We identified all children recorded in the Patient Registry with a hospital discharge diagnosis of Brachialis Plexus Birth Injury (BPBI) according to the following ICD10 (P14.0, P14.1, P14.2, P 14.3, P14.8, P14.9 and T92.4) or ICD9 codes (767.4, 767.6, 767.7, and 907.4) [37]
Since prescription– and use–of psychotropic medication is a clear indicator of psychological health impairment, these findings suggest that adolescents with a BPBI may be in higher risk for impaired mental health
Summary
Child chronic illness may cause deep, long-lasting crisis in affected families [1,2,3]. Parents coping with child chronic illness or injury/handicap are under considerable stress, if problems start already at the child’s birth [6,7,8,9]. Plexus injury at birth and mental health in adolescence, using psychotropic drug use as indicator provide individual level data to researchers abroad. Instead, they normally advise researchers in other countries to cooperate with Swedish colleagues, to whom they can provide data according to standard legal provisions and procedures. Requests for access to the data can be made to the National Board of Health and Welfare and Statistics Sweden (http://www.socialstyrelsen.se/statistics; https:// www.scb.se/en/services/guidance-for-researchersand-universities/)
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