Clinical factors associated with mood affective disorders among adults with cerebral palsy

Daniel G. Whitney*, Seth A. Warschausky, Daniel Whibley, Anna Kratz, Susan L. Murphy, Edward A. Hurvitz, Mark D. Peterson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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. International Classification of Diseases, Tenth Revision, Clinical Modification 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.
Original languageEnglish
Pages (from-to)206-213
Number of pages8
JournalNeurology: Clinical Practice
Issue number3
Early online date16 Sept 2019
Publication statusPublished - Jun 2020

Bibliographical note

DGW - Research Support, Academic Entities:
University of Michigan Diversity Fund to support Dr. Whitney's research

SAW - Research Support, Government Entities:
NIH: U060371 06/2017-02/2022; HD095957 08/2018 - 07/2023 NIDLRR RERC: H133E130014 10/2013-09/2018

DW - Research Support, Foundations and Societies:
Versus Arthritis (formerly Arthritis Research UK), Foundation Fellowship, grant number 21742

SLM - I am funded by the VA as a research health science specialist. I have received funding from the VA rehabilitation research and development branch for my research --VA Ann Arbor Health Care System (Murphy, PI) 10/01/2014 - 09/30/2015 VA Innovations Grant for the Advancement of Veteran Centered Care—VISN 11 Integrating Acupressure into Pain Management for Veterans with Chronic Low Back Pain The goal of this project is to test the feasibility of a patient-centered approach to pain management in which veterans receiving care at a physical medicine clinic will be able to try acupressure via website and receive in- person training as needed. --E7557R (Murphy, PI) 10/01/2010 – 09/30/2013 VA Rehabilitation Research and Development Branch Effectiveness of Tailored Activity Pacing for Symptomatic Osteoarthritis. This merit study was a clinical trial with three arms: tailored activity pacing, general activity pacing, and usual care for veterans with knee or hip osteoarthritis. --1I01RX000736-01 (Murphy, PI) 04/01/2012 – 03/31/2014 VA Rehabilitation Research and Development Branch Effectiveness of Tailored Activity Pacing for Chronic Low Back Pain. The aims were to adapt a tailored activity pacing intervention for clinical use and to pilot-test the intervention. --VA Rehab Research & Development. Merit Grant; Fatigue and Physical Activity among Older Adult Leg Osteoarthritics, $742,515; co-PI: Murphy, 38% effort, 10/08 – 10/11
Research Support, Foundations and Societies:
Scleroderma Foundation (Murphy, Khanna, co-PIs) 04/01/2018 – 3/31/2020 Occupational Therapy versus Home Exercise to Increase Upper Extremity Function in Individuals with Systemic Sclerosis: A pilot randomized controlled trial.


Dive into the research topics of 'Clinical factors associated with mood affective disorders among adults with cerebral palsy'. Together they form a unique fingerprint.

Cite this