Psychiatric problems in children with hemiplegia: cross sectional epidemiological survey.
OBJECTIVE
To examine the prevalence and predictors of psychiatric problems in children with hemiplegia.


METHODS
Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later.


METHODS
428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed.


METHODS
Psychiatric symptom scores and the occurrence of psychiatric disorder.


RESULTS
Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power.


CONCLUSIONS
Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented.
Goodman
R
R
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London.
Graham
P
P
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006429:Hemiplegia / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007360:Intelligence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012923:Social Class