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Adults With Cerebral Palsy: Physical and Mental Health Comorbidities and Health Service Use

Applied Health Research Question submitted to H-CARDD by the Toronto Rehabilitation Institute
Authors: Carly McMorris, Kristin Dobranowski, Johanna Lake, Caitlin McGarry, Yona Lunsky, & Robert Balogh

Background

Individuals with cerebral palsy experience high rates of secondary, associated, and comorbid physical and mental health problems which exacerbate their condition and may lead to death. The presence of a comorbid developmental disability among individuals with cerebral palsy may increase the risk for additional physical and mental health problems. As individuals with cerebral palsy age, the risk for developing medical issues and the need for health care support increases. However, compared to the pediatric system, fewer medical and psychiatric services exist for adults with cerebral palsy.

Purpose

The purpose of this report was to conduct a comprehensive literature review of the occurrence of physical and mental health problems in adults with cerebral palsy, with and without developmental disabilities, and to examine health service use patterns in this population.

Methods

A literature review was conducted using Medline, EMBASE, Psycinfo, and Web of Science. Articles were required to: present findings on individuals with cerebral palsy (not specific to type of cerebral palsy); include a sample of adults 18 years or older; and be related to physical health, mental health, or health service use. Fifteen articles were reviewed.

Results

  • Adults with cerebral palsy presented with a number of comorbid physical and mental health problems. However, it remains unclear what and how demographic or clinical factors, including the presence of a developmental disability, impact physical health.
  • Depression, aggression, self-injury, and stereotyped behaviour were common psychiatric issues noted among adults with cerebral palsy.
  • Adults with cerebral palsy were less likely than youth with cerebral palsy to receive routine preventive care and were frequently hospitalized for physical conditions.
  • Adults with mild cerebral palsy were even less likely to receive routine preventive care than those with severe cerebral palsy.

Conclusions and Implications

A number of gaps exist in the literature. These include: studies comparing adults with cerebral palsy, with and without developmental disabilities, to each other and to adults without developmental disabilities; studies examining the relationship between the presence of developmental disabilities, or severity of cerebral palsy, and comorbid physical and mental health problems; and studies examining how demographic and clinical factors impact health service use and the prevalence of physical and mental health problems among adults with cerebral palsy with and without developmental disabilities.