Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy.
OBJECTIVE
To investigate the prevalence and co-occurrence of chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy (SBCP) and explore associations of chronic pain and fatigue with depressive symptoms and daily functioning.


METHODS
Fifty-six adults with SBCP without severe cognitive impairment participated (35 males, 21 females; mean age 36y 5mo, SD 5y 10mo; Gross Motor Function Classification System level I [13], II [28], III [11], IV [4]). Chronic pain (>3mo), severity and nature of fatigue (Fatigue Severity Scale; Multidimensional Fatigue Inventory), and depressive symptoms (Center for Epidemiological Studies Depression Scale) were assessed. Associations were explored using multivariable logistic regression analyses.


RESULTS
The study sample had a higher prevalence of chronic pain (75% vs 39%; p<0.001), mean fatigue (Fatigue Severity Scale, 4.4 [SD 1.3] vs 2.9 [SD 1.1]; p<0.001), and prevalence of depressive symptoms (25% vs 12%; p=0.004) than Dutch healthy reference samples. Chronic pain and severe fatigue co-occurred in 34% and in combination with depressive symptoms in 16% of the participants. Severity of fatigue was associated with depressive symptoms (OR 3.38; p<0.01). Chronic pain and fatigue were not associated with limitations in daily functioning.


CONCLUSIONS
These findings suggest that adults with SBCP are severely affected by chronic pain, fatigue, and depressive symptoms, in addition to their spastic paresis.
Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. w.vanderslot@erasmusmc.nl
Wilma M A
WM
Van Der Slot
Channah
C
Nieuwenhuijsen
Rita J G
RJ
Van Den Berg-Emons
Michael P
MP
Bergen
Sander R
SR
Hilberink
Henk J
HJ
Stam
Marij E
ME
Roebroeck
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D004185:Disability Evaluation; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000523:psychology*; D009426:Netherlands; D009460:Neurologic Examination; D010809:Physical Fitness