Clinical factors associated with mood affective disorders among adults with cerebral palsy

Daniel G. Whitney*, Seth A. Warschausky, Daniel Whibley, Anna Kratz, Susan L. Murphy, Edward A. Hurvitz, Mark D. Peterson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)206-213
Number of pages8
JournalNeurology: Clinical Practice
Issue number3
Early online date16 Sep 2019
Publication statusPublished - Jun 2020


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