脑瘫成人中与情感性精神障碍相关的临床因素。
Clinical factors associated with mood affective disorders among adults with cerebral palsy.
作者信息
Whitney Daniel G, Warschausky Seth A, Whibley Daniel, Kratz Anna, Murphy Susan L, Hurvitz Edward A, Peterson Mark D
机构信息
Department of Physical Medicine and Rehabilitation (DGW, SAW, DW, AK, SLM, EAH, MDP), University of Michigan; University of Michigan (DGW, MDP), Institute for Healthcare Policy and Innovation; University of Michigan (DGW), University of Michigan Depression Center, Ann Arbor, MI; and Epidemiology Group (DW), University of Aberdeen, School of Medicine, Medical Sciences and Nutrition, Scotland, UK.
出版信息
Neurol Clin Pract. 2020 Jun;10(3):206-213. doi: 10.1212/CPJ.0000000000000721.
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. 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.
目的
确定脑瘫（CP）相关症状的个体及总体关联，以及合并神经发育障碍对成年CP患者情绪（情感）障碍的影响。
方法
从医疗保险按服务收费数据库中随机抽取20%的样本，提取2016年的横断面数据。使用诊断代码识别18至64岁的CP患者，以及情绪（情感）障碍、疼痛、睡眠障碍、疲劳和合并神经发育障碍（智力残疾[ID]、自闭症谱系障碍[ASD]和癫痫）。
结果
17212名成年CP患者中，4823人患有情绪（情感）障碍（28.0%）。在调整年龄、性别和种族后，疼痛（比值比[OR]=2.15；99.5%置信区间[CI]=1.94 - 2.39）、睡眠障碍（OR = 2.43；99.5% CI = 2.13 - 2.77）、疲劳（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）和癫痫（OR = 0.81；99.5% CI = 0.73 - 0.91）均与情绪（情感）障碍相关。当将疼痛、睡眠障碍和疲劳作为计数变量呈现时，情绪（情感）障碍的调整后比值随因素数量增加而升高：1个因素（OR = 1.99；99.5% CI = 1.79 - 2.
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