Screening for psychopathology in a national cohort of 8- to 15-year-old children with cerebral palsy

Abstract

Cerebral palsy (CP) is often accompanied by psychopathology and learning disability. Aims(1) to evaluate the prevalence of psychopathology as estimated by the Child Behavior Checklist (CBCL) parental questionnaire in 8- to 15-year-old Danish children with CP and to analyze its association with cognitive ability and families’ social characteristics; (2) to examine to what extent children with CP had been evaluated by a child psychiatrist and/or psychologist. MethodThe parents of 462 children with CP answered a questionnaire about their child's treatment and the family's characteristics and 446 the CBCL. The cutoff for psychopathology was the Total CBCL score or DSM-oriented scores above the 93rd percentile in an age- and gender-stratified population. ResultsThe psychopathology screening was positive in 46.2% (CI 41.6–50.8%) against 15.1% in general population. Cognitive disability was associated with an increased prevalence of psychopathology (odds ratio (OR) 2.6, CI 1.4–4.6, for Developmental Quotient of cognitive function (DQ) 50–85 and OR 3.0, CI 1.3–7.0, for DQ<50). Children with CP and a single parent showed increased odds for a positive CBCL screening compared to children living with two parents (OR 2.1, 95% CI 1.1–4.0). Children with DQ 50–85 more often had a psychological evaluation. A positive CBCL screening was strongly associated with a psychiatric assessment (21% vs. 7%, p<0.01). ConclusionThe high prevalence of emotional and behavioral problems indicates that screening for psychopathology should be a part of multidisciplinary follow-up of CP. The CBCL can be used as a screening instrument in children with CP without severe motor and cognitive disability.