Trajectories of Psychiatric Disorders in a Cohort of Children with Cerebral Palsy across Four Years
Open accessAbstract
BACKGROUND: Risk of psychiatric disorders has been reported for children and adolescents with cerebral palsy (CP) at different ages, however little is known regarding the long-term trajectories of these disorders. OBJECTIVE: The aim of this study was to assess the trajectories of psychiatric disorders in children with CP, and to explore their association to risk factors. METHODS: We assessed a cohort of children with CP at age seven and again at age eleven with a child psychiatric diagnostic instrument, and parents were informants. We assessed type of CP, Gross Motor Function Classification System (GMFCS) levels, and co-occurring medical conditions in a medical examination, through the medical records, and in an interview with the parents at the onset of the study. RESULTS: We found a significant increase in the prevalence of emotional disorders from seven to eleven years of age (p 0.01), whereas the prevalence of behavioral disorders was stable. Half of the cohort met criteria for a psychiatric disorder at both assessment points. Type of CP, spastic bilateral or unilateral, dyskinetic or ataxic, and co-occurring medical conditions were non-significant predictors of psychiatric disorders. Subthreshold psychiatric disorders at age seven were predictive of psychiatric disorders at age eleven. CONCLUSIONS: We found a persistently elevated prevalence of psychiatric disorders in children with CP. Prevalence of behavioral disorders was stable, whereas we found a significant four-fold increase in emotional disorders. Sub-threshold psychiatric disorders predicted later psychiatric disorders. Increased focus on early mental health symptoms as well as more knowledge regarding emotional disorders in children with CP seems warranted.
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Half of the cohort met the criteria for a psychiatric disorder at both assessment points.
“Half of the cohort met the criteria for a psychiatric disorder at both assessment points.”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
Bjorgaas et al. found a significant increase in the prevalence of emotional disorders from 7 to 11 years of age, while the prevalence of behavioral disorders remained stable.
“They found a significant increase in the prevalence of emotional disorders (which included anxiety and affective disorders) from 7 to 11 years of age, while the prevalence of behavioral disorders (encompassing conduct disorder, oppositional defiant disorder, and hyperactivity/attention deficit disorders) remained stable [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
Subthreshold psychiatric disorders at age 7 were predictive of psychiatric disorders at age 11.
“The study revealed that subthreshold psychiatric disorders at age 7 were predictive of psychiatric disorders at age 11 [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
The trajectory of behavioral disorders, of which ADHD/ADD was the most common, was stable across the study interval spanning ages 7 to 11 years.
“The trajectory of diagnoses was examined by one study, which found that the trajectory of behavioral disorders, of which ADHD/ADD was the most common, was stable across the study interval (spanning the ages of 7 years old and 11 years old) [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
Youth with CP demonstrated a four-fold increase in emotional disorders between the ages of 7 and 11.
“Authors found that youth with CP demonstrated a four-fold increase in emotional disorders between the ages of 7 and 11 [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
The presence of behavioral disorders at age 7 is associated with the presence of emotional disorders at age 11 in children with CP.
“Authors also reported an association between the presence of behavioral disorders at age 7 and the presence of emotional disorders at age 11”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
Early behavioral disorders may be a risk factor for later emotional symptoms in children with CP.
“positing that early behavioral disorders may be a risk factor for later emotional symptoms [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
Symptoms of mental health concerns at an early age are predictive of mental health concerns at a later age for children with CP.
“Symptoms of mental health concerns at an early age are predictive of mental health concerns at a later age for this population [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
Behavioral concerns appear to be common in children with CP, and the presence of early behavioral concerns (including ADHD and oppositional defiant disorder) is associated with later emotional disorders.
“Behavioral concerns appear to be common in children with CP, and the presence of early behavioral concerns (including ADHD and oppositional defiant disorder) is associated with later emotional disorders [14].”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [14]
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Self-citation
- Authors
- Bjorgaas, H. M., Elgen, I. B., & Hysing, M.
- Affiliations
- University of Bergen (NO)
- Venue
- Disability and Health Journal
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 14
- Issue
- 1
- Pages
- 100992
- ISSN
- 1876-7583 (ISSN-L)
- 1936-6574
- OpenAlex
- W3086345264
- Cited by
- 21
- References
- 41
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 4 · 2023: 1 · 2022: 6 · 2021: 2
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Disability and health journal (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
- Funders
- Western Health Region Research Funding, Norway
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- cerebral palsy, mental illness, emotional disorders, behavioral disorders, longitudinal trajectories, children, risk factors, Gross Motor Function Classification System, spastic cerebral palsy, dyskinetic cerebral palsy, ataxic cerebral palsy, comorbidities
- MeSH terms
- Adolescent, Mental Disorders, Cerebral Palsy, Child, Persons with Disabilities, Humans, Cohort Studies, Prevalence
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