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Pediatrics

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1148 - Electronic Medical Record Characterization of Mental Health Diagnoses in Children with Cerebral Palsy

Friday, February 23, 2024
5:00 PM – 6:30 PM EDT
Objectives: To characterize the distribution of mental health (MH) diagnoses amongst children with cerebral palsy (CP) and compare to typically developing (TD) and chronic condition (CC) pediatric populations.

Design: Retrospective analysis of an Electronic Medical Record (EMR) from a large tertiary care children’s hospital in Ohio. Data from January 1st, 2010, until December 31st, 2022 were extracted. We included children between 0-21 years and used International Classification of Diseases (ICD) codes to create three groups: CP, CC, and TD. Case-control matching was performed to control for demographic factors. MH diagnosis codes were extracted for each group. Descriptive and comparative statistics were used.

Results: Our final cohort comprised of 250,277 individuals with a mean age of 4.3 years (stdv = 4.8) at first EMR encounter: CP(n=3,378, 44% F; 74% White), CC (n=155,395, 46% F; 74% White), and TD (n=91,504, 46% F; 71% White). There was a significant (p< 0.01) difference between CP and CC groups for anxiety (25% vs. 19.7%), depression (3.7% vs. 10%), and conduct/impulse (15.3% vs. 9.9%) and between CP and TD groups for anxiety (25% vs. 9.4%), depression (3.7% vs. 6.9%), conduct/impulse (15.3% vs. 4.9%), and ADHD (15.6% vs. 8.2%) diagnoses.

Conclusions: There is potential under-recognition of depression in children with CP. ADHD frequency in CP is similar in other chronic conditions, and higher than a typically developing comparison. Anxiety and conduct/impulse appear to be higher in CP. There is likely a need for assessment tools that are appropriately tailored to CP. Limitations include the retrospective design and ICD code use rather than psychiatric interviews. Future research should evaluate the reasons behind these differences and understand optimal identification and management approaches.