脑瘫成年人精神健康障碍的患病率：一项横断面分析。
Prevalence of Mental Health Disorders Among Adults With Cerebral Palsy: A Cross-sectional Analysis.
机构信息
Michigan Medicine, the University of Michigan Depression Center, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan (D.G.W.).
Michigan Medicine, University of Michigan, Ann Arbor, Michigan (S.A.W., E.A.H.).
出版信息
Ann Intern Med. 2019 Sep 3;171(5):328-333. doi: 10.7326/M18-3420. Epub 2019 Aug 6.
BACKGROUND
Persons with cerebral palsy (CP) have an increased risk for secondary chronic conditions during childhood, including mental health disorders. However, little is known about how these disorders affect adults with CP.
OBJECTIVE
To determine the prevalence of mental health disorders among adults with CP compared with those without CP.
DESIGN
Cross-sectional.
SETTING
2016 Optum Clinformatics Data Mart.
PATIENTS
8.7 million adults (including 7348 adults with CP).
MEASUREMENTS
Other neurodevelopmental comorbid conditions (intellectual disabilities, autism spectrum disorders, epilepsy) and 37 mental health disorders (as 6 categories) were identified on the basis of diagnosis codes. Direct age-standardized prevalence of the mental health disorder categories was estimated by sex for adults with CP alone, adults with CP and neurodevelopmental disorders, and adults without CP.
RESULTS
Men with CP alone had higher age-standardized prevalence than men without CP for schizophrenic disorders (2.8% [95% CI, 2.2% to 3.4%] vs. 0.7%), mood affective disorders (19.5% [CI, 18.0% to 21.0%] vs. 8.1%), anxiety disorders (19.5% [CI, 18.0% to 21.0%] vs. 11.1%), disorders of adult personality and behavior (1.2% [CI, 0.8% to 1.6%] vs. 0.3%), and alcohol- and opioid-related disorders (4.7% [CI, 3.9% to 5.5%] vs. 3.0%). The same pattern was observed for women. Compared with adults with CP alone, those with CP and neurodevelopmental disorders had similar or higher age-standardized prevalence of the 6 mental health disorder categories, except for the lower prevalence of alcohol- and opioid-related disorders in men.
LIMITATIONS
Single claims code was used to define the cohort of interest. Information on the severity of CP was not available.
CONCLUSION
Compared with adults without CP, those with CP have an elevated prevalence of mental health disorders, some of which may be more pronounced in patients with comorbid neurodevelopmental disorders.
PRIMARY FUNDING SOURCE
National Institute on Disability, Independent Living, and Rehabilitation Research.
背景
脑瘫（CP）患者在儿童时期患继发性慢性疾病的风险增加，包括精神健康障碍。然而，对于这些障碍如何影响成年 CP 患者知之甚少。
目的
确定与无 CP 患者相比，CP 成年患者的精神健康障碍患病率。
设计
横断面研究。
设置
2016 年 Optum Clinformatics 数据集市。
患者
7348 名成年 CP 患者（共 870 万成年人）。
测量
基于诊断代码，确定了其他神经发育合并症（智力障碍、自闭症谱系障碍、癫痫）和 37 种精神健康障碍（6 个类别）。仅 CP 患者、CP 和神经发育障碍患者以及无 CP 患者的精神健康障碍类别，通过直接年龄标准化患病率进行估计。
结果
CP 男性患者的精神分裂症障碍、心境情感障碍、焦虑障碍、成人人格和行为障碍以及酒精和阿片类物质相关障碍的年龄标准化患病率均高于无 CP 男性患者（分别为 2.8%[95%CI，2.2%3.4%]比 0.7%、19.5%[CI，18.0%21.0%]比 8.1%、19.5%[CI，18.0%21.0%]比 11.1%、1.2%[CI，0.8%1.6%]比 0.3%和 4.7%[CI，3.9%~5.5%]比 3.0%），而 CP 女性患者也呈现相同的模式。与仅 CP 患者相比，CP 和神经发育障碍患者的 6 种精神健康障碍类别的年龄标准化患病率相似或更高，除了男性酒精和阿片类物质相关障碍的患病率较低。
局限性
仅使用单一的索赔代码来定义感兴趣的队列。CP 严重程度的信息不可用。
结论
与无 CP 成人相比，CP 成人的精神健康障碍患病率更高，其中一些障碍在合并神经发育障碍的患者中可能更为明显。
主要资金来源
国立残疾、独立生活和康复研究学会。
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