Risikofaktoren für psychische Auffälligkeiten von Kindern und Jugendlichen mit Infantiler Zerebralparese und Spina bifida

Zusammenfassung

Hintergrund Kinder und Jugendliche mit infantiler Zerebralparese (CP) und mit Spina bifida (SB) haben ein erhöhtes Risiko für psychische Auffälligkeiten. Ziel dieser Studie war es, im Vergleich beider Gruppen krankheitsspezifische und psychosoziale Risikofaktoren mit der qualitativen Ausprägung psychischer Auffälligkeiten zu korrelieren.

Patienten In einer multizentrischen Querschnittstudie wurden 271 Patienten mit CP und 84 mit SB (Alter 3–17 Jahre) eingeschlossen.

Methoden Die Eltern beantworteten die Strengths and Difficulties Questionnaire (SDQ), machten Angaben zum soziodemografischen Status und zur sozialen Teilhabe ihrer Kinder. Daten zum kognitiven, motorischen und sozialen Funktionsniveau der Patienten wurden aus den Akten bzw. durch die behandelnden Pädiater erhoben.

Ergebnisse 30,2% der CP und 18,1% der SB Patienten zeigten einen auffälligen SDQ-Gesamtproblemwert (Norm 10,0%). Erhöhte Prävalenzen bestanden fort, wenn für den IQ als Kovariate kontrolliert wurde. In beiden Gruppen wurden Korrelationen zwischen externalisierenden Auffälligkeiten (Verhaltensprobleme, Hyperaktivität) und Schweregrad (IQ-Minderung; motorische Beeinträchtigung) gefunden. Emotionale Probleme korrelierten – unabhängig vom Schweregrad – mit der sozialen Teilhabe. In beiden Gruppen bestanden nur schwache Zusammenhänge mit Alter und Geschlecht. Bei Berücksichtigung des IQ als Kovariate bestanden keine Gruppenunterschiede in der psychischen Symptomatik zwischen CP und SB-Patienten.

Schlussfolgerung Psychische Auffälligkeiten bei Kindern und Jugendlichen mit CP bzw. SB korrelieren mit verschiedenen Risikofaktoren (IQ, motorische Beeinträchtigung, Alter, Geschlecht, Teilhabe). Eine Verbesserung ihrer Früherkennung, der Teilhabe und psychotherapeutische Angebote sind erforderlich.

Abstract

Background Children with cerebral palsy (CP) and spina bifida (SB) are at an increased risk for mental health problems. Aim of this study was to correlate disease specific and psychosocial risk factors with characteristic mental health problems.

Patients 271 children with CP and 84 with SB aged 3–17 years were included in a cross sectional study of 15 centers.

Methods Parents answered the Strengths and Difficulties Questionnaire (SDQ) for mental health problems, rated social participation of their children and gave data to their own educational and professional level. IQ and motor impairment were tested or rated by the caring pediatricians.

Results Abnormal Total-Difficulties Scores were found in CP (30,2%) and SB (18,1%) as compared to the norm (10,0%). Increased prevalences persisted after controlling for IQ as covariate. In both groups, moderate correlations between externalizing problems and levels of cognitive and motor impairment were found. Emotional problems correlated with participation irrespective of level of impairment. Weak correlations were found with age and gender in both groups. After controlling for IQ as covariate mental health problems showed no systematic difference between both groups.

Discussion Mental health problems in children and youth with CP and SB are frequent. They correlated with various risk factors (IQ, motor impairment, age, gender, participation). Early recognition, participation and psychotherapeutic facilities should be strengthened.

Schlüsselwörter

Zerebralparese - Spina bifida - psychische Auffälligkeiten - Kognition - Partizipation

Key words

cerebral palsy - spina bifida - mental health - cognition - participation

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