Psychiatric disorders after childhood stroke.
OBJECTIVE
To determine the rate, types, and correlates of psychiatric disorder (PD) following stroke and orthopedic disorders in children and adolescents.


METHODS
Children aged 5 to 19 were assessed. The study used a cross-sectional design that compared 29 stroke subjects with 29 congenital clubfoot or scoliosis subjects. Assessments of psychiatric status; cognitive, adaptive, academic, and family functioning; family psychiatric history; neuroimaging; and neurological status were conducted. The main outcome measure was a current PD not present before the stroke or orthopedic disorder.


RESULTS
Poststroke PD occurred significantly more often than postorthopedic diagnosis PD (17/29 [59%] versus 4/29 [14%], p < or =.001). Subjects with ongoing poststroke PD had significantly more impaired intellectual and adaptive functioning, higher intensity family psychiatric history scores, and tended toward higher neurological severity index scores, but they were not different regarding lesion volume or family functioning compared with stroke subjects without PD. Regression analyses showed that neurological severity and family psychiatric history independently contributed significantly to predicting PD.


CONCLUSIONS
The data suggest that there are significant biopsychosocial correlates of PD in children with focal neurological lesions. These include a relatively abnormal neurological exam, lower IQ, and increased family psychopathology.
Max
Jeffrey E
JE
University of California, San Diego and Children's Hospital and Health Center, USA. jmax@ucsd.edu
Mathews
Katherine
K
Lansing
Amy E
AE
Robertson
Brigitte A M
BA
Fox
Peter T
PT
Lancaster
Jack L
JL
Manes
Facundo F
FF
Smith
Jennifer
J
D000293:Adolescent; D001925:Brain Damage, Chronic / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D012307:Risk Factors; D012600:Scoliosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D020521:Stroke / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D014481:United States