Psychiatric Disorders after Childhood Stroke

Jeffrey E. Max*, Katherine Mathews, Amy E. Lansing, Brigitte A M Robertson, Peter T. Fox, Jack L. Lancaster, Facundo F. Manes, Jennifer Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

66 Citations (Scopus)

Abstract

Objectives: To determine the rate, types, and correlates of psychiatric disorder (PD) following stroke and orthopedic disorders in children and adolescents. Method: 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 ≤ .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.

Original languageEnglish
Pages (from-to)555-562
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume41
Issue number5
DOIs
Publication statusPublished - May 2002
Externally publishedYes

Keywords

  • Pediatric
  • Psychopathology
  • Stroke

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