Cerebral palsy (CP), as with many chronic illnesses, is characterized by anxiety and depression. Depression and anxiety are frequently experienced mental illnesses, and there is a 2- to 3-fold increase in the likelihood that patients with chronic medical conditions or disability would have anxiety or depression.
People with cerebral palsy will face some challenges as they age which could be associated with increased risk of developing anxiety and depression. Substantial evidence indicates that 20% to 25% of adults with CP have clinically significant levels of depressive symptoms. A recent longitudinal study conducted in the UK showed that adults with CP had a higher risk for depression (43%) than those without motor disorder. It also revealed that they also had a 40% increased risk for anxiety.
Often diagnosed in early childhood, cerebral palsy is often referred to as a pediatric condition but manifests throughout their lifetime. Its occurrence has been attributed to nonprogressive disturbances in developing fetal or infant brain which results in a group of disorders impairing motor function thereby affecting the movement and posture of the person. People diagnosed with cerebral palsy have cognitive and sensory impairments and experience seizure disorders and nutritional deficiencies. Evidence shows that deterioration in physical functioning and an increase in secondary health conditions occurs with time.
According to a journal published by Kimberley J. Smith, Ph.D., Department of Psychological Sciences, Faculty of Health and Medical Sciences, University of Surrey, United Kingdom, people with CP had a higher risk of being diagnosed for depression or anxiety, compared with a matched control group of adults without the condition. Possible reasons for these results could be because adults with cerebral palsy present with a diverse range of physiological, psychological, social, and health-related risk factors that are associated with depressive symptoms and anxiety in the general population including multimorbidity, increased pain, functional limitations, noncommunicable diseases, difficulties with social relationships and poorer sleep.
Also, it is estimated that approximately one-third of individuals with CP experience comorbid intellectual disability (ID), therefore some researchers have proposed that presence or absence of ID could affect the results of research on the risk of anxiety and depression in individuals with CP. A research was conducted to determine whether the presence of comorbid ID impacted on the associations between CP and incident depression and anxiety. During the follow-up period of the research, there were 1179 new events of depression following the index date. In total, 867 people (17.0%) from the reference group had a new event of depression during a median of 9.1 (range, 0.01-28.01) years of follow-up. In total, 312 patients (18.3%) with CP had a new event of depression during a median of 5.7 (range, 0.001-27.9) years of follow-up. Patients with CP had an increased hazard of depression compared with matched patients without CP (hazard ratio [HR], 1.43; 95% CI, 1.24-1.64). This association remained statistically significant (HR, 1.28; 95% CI, 1.09-1.51) after controlling for other chronic conditions and the mean number of GP visits.
The research revealed that ID comorbidity should be considered when assessing the mental health of adults with CP. It also showed that the risk of depression and anxiety was higher in adults with CP who did not have ID, when compared with the matched reference group. Furthermore, adults with CP and ID had similar hazards of developing depression and anxiety to the matched reference group.