Psychological Problems in Children with Cerebral Palsy: A Cross-Sectional European Study
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OBJECTIVES: To describe psychological symptoms in 8-12-year-old children with cerebral palsy; to investigate predictors of these symptoms and their impact on the child and family. DESIGN: A cross-sectional multi-centre survey. PARTICIPANTS: Eight hundred and eighteen children with cerebral palsy, aged 8-12 years, identified from population-based registers of cerebral palsy in eight European regions and from multiple sources in one further region. MAIN OUTCOME MEASURES: The Strengths and Difficulties Questionnaire (SDQ)(P4-16) and the Total Difficulties Score (TDS) dichotomised into normal/borderline (TDS < or = 16) versus abnormal (TDS > 16). STATISTICAL ANALYSIS: Multilevel, multivariable logistic regression to relate the presence of psychological symptoms to child and family characteristics. RESULTS: About a quarter of the children had TDS > 16 indicating significant psychological symptoms, most commonly in the domain Peer Problems. Better gross motor function, poorer intellect, more pain, having a disabled or ill sibling and living in a town were independently associated with TDS > 16. The risk of TDS > 16 was odds ratio (OR) = .2 (95% CI: .1 to .3) comparing children with the most and least severe functional limitations; OR = 3.2 (95%CI: 2.1 to 4.8) comparing children with IQ < 70 and others; OR = 2.7 (95% CI: 1.5 to 4.6) comparing children in severe pain and others; OR = 2.7 (95% CI:1.6 to 4.6) comparing children with another disabled sibling or OR = 1.8 (95%CI: 1.2 to 2.8) no siblings and others; OR = 1.8 (95% CI: 1.1 to 2.8) comparing children resident in a town and others. Among parents who reported their child to have psychological problems, 95% said they had lasted over a year, 37% said they distressed their child and 42% said they burdened the family at least 'quite a lot'. CONCLUSIONS: A significant proportion of children with cerebral palsy have psychological symptoms or social impairment sufficiently severe to warrant referral to specialist services. Care must be taken in the assessment and management of children with cerebral palsy to ensure psychological problems are not overlooked and potentially preventable risk factors like pain are treated effectively. The validity of the SDQ for children with severe disability warrants further assessment.
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A significant proportion of children with cerebral palsy experience psychological symptoms or social impairment.
“a significant proportion of these children experience psychological symptoms or social impairment [5]”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [5]
A significant proportion of the CP population is at high risk for poor mental health.
“and that a significant proportion of this population is at high risk for poor mental health [5]”
From The Mental Health of Children with Cerebral Palsy: A Review of the Last Five Years of Research (2025) · cites this paper as [5]
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- Authors
- Parkes, J., White‐Koning, M., Dickinson, H. O., Thyen, U., Arnaud, C., Beckung, E., Fauconnier, J., Marcelli, M., McManus, V., Michelsen, S. I., Parkinson, K., & Colver, A.
- Affiliations
- Queen's University Belfast (GB)
- Newcastle University (GB)
- University Hospital Schleswig-Holstein (DE)
- Université Toulouse III - Paul Sabatier (FR)
- Drottning Silvias barn- och ungdomssjukhus (SE)
- Azienda Sanitaria Locale Viterbo (IT)
- Enable Ireland (IE)
- Danish National Institute of Public Health (DK)
- Royal Victoria Infirmary (GB)
- Corresponding author
- Parkes, Jackie
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2008-01-21
- Volume
- 49
- Issue
- 4
- Pages
- 405-413
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2019333483
- Cited by
- 244
- References
- 43
- Citations by year
- 2026: 6 · 2025: 19 · 2024: 12 · 2023: 8 · 2022: 10 · 2021: 11 · 2020: 19 · 2019: 12 · 2018: 13 · 2017: 12 · 2016: 9 · 2015: 15 · 2014: 12 · 2013: 22 · 2012: 23
- FWCI
- 9.34
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- HAL (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Fondation Motrice
- European Commission
- 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, psychological symptoms, children, peer problems, social dysfunction, gross motor function, intellectual disability, pain, siblings, family burden, Strengths and Difficulties Questionnaire, specialist referral, urban residence, parental distress
- MeSH terms
- Affective Symptoms, Cerebral Palsy, Child, Child Behavior Disorders, Cross-Sectional Studies, Disability Evaluation, Europe, Female, Health Surveys, Humans, Male, Intellectual Disability, Pain, Peer Group, Personality Assessment, Referral and Consultation, Risk Factors, Sick Role, Social Adjustment, Social Environment, Comorbidity, Siblings
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