Effect of pain on mood affective disorders in adults with cerebral palsy

Daniel G. Whitney* (Corresponding Author), Sarah Bell, Daniel Whibley, Wilma M A Van der Slot , Edward A. Hurvitz, Heidi J Haapala, Mark D Peterson, Seth A. Warschausky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Aim: To determine if pain is associated with 12-month incidence of mood affective disorders (MAD) in adults with cerebral palsy (CP). Method: Data from Optum Clinformatics ® Data Mart (2013–2016) were used for this retrospective cohort study. Diagnostic codes were used to identify adults (≥18y) with CP, incident cases of MAD, and covariates (other neurodevelopmental conditions, sleep disorders, arthritis). Pain (any type, location) was identified between 1st October 2014 and 30th September 2015. The pain group was divided into new or consistent pain if they had a history of pain (i.e. consistent) in the 12 months before their first pain claim date. Crude incidence rates of MAD (expressed per 100 person-years) were estimated. Cox regression was used to estimate hazard ratio (95% confidence interval [CI]) of MAD after adjusting for covariates. Results: Adults that had new pain (n=859; incidence rate=15.5) or consistent pain (n=1303; incidence rate=17.9) had greater crude incidence rate of MAD compared to adults without pain (n=3726; incidence rate=5.9). The elevated rate of MAD remained after adjusting for covariates, for new pain (hazard ratio=2.4; 95% CI=1.9–3.0) and consistent pain (hazard ratio=2.1; 95% CI=1.7–2.7). Interpretation: Pain is associated with greater incidence of MAD in adults with CP. This association remained after accounting for potential confounding factors. What this paper adds: What this paper adds Pain was associated with higher 12-month incidence of mood affective disorders (MAD). The 12-month MAD incidence was similar between new and consistent pain groups. The MAD incidence remained higher adjusting for neurodevelopmental comorbidities, sleep disorders, and arthritis.

Original languageEnglish
Pages (from-to)926-932
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Issue number8
Early online date4 May 2020
Publication statusPublished - 1 Aug 2020

Bibliographical note

All authors declare no conflict of interest. Daniel G Whitney is supported by the University of Michigan Office of Health Equity and Inclusion Diversity Fund and American Academy of Cerebral Palsy and Developmental Medicine. Seth A Warschausky is funded by the National Institutes of Health (5 UL1 TR002240‐05) and the Mildred E Swanson Foundation. The funding sources had no role in the design or conduct of the study; collect, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.




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