Chronic pain, fatigue, and depressive symptoms in adults with spastic bilateral cerebral palsy

Dev Med Child Neurol. 2012 Sep;54(9):836-42. doi: 10.1111/j.1469-8749.2012.04371.x. Epub 2012 Jul 19.


Aim: 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.

Method: 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.

Interpretation: These findings suggest that adults with SBCP are severely affected by chronic pain, fatigue, and depressive symptoms, in addition to their spastic paresis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / classification
  • Activities of Daily Living / psychology
  • Adult
  • Cerebral Palsy / diagnosis
  • Cerebral Palsy / epidemiology
  • Cerebral Palsy / psychology*
  • Chronic Pain / diagnosis
  • Chronic Pain / epidemiology
  • Chronic Pain / psychology*
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology*
  • Disability Evaluation
  • Fatigue / epidemiology
  • Fatigue / psychology*
  • Female
  • Humans
  • Male
  • Musculoskeletal Pain / epidemiology*
  • Musculoskeletal Pain / psychology*
  • Netherlands
  • Neurologic Examination
  • Physical Fitness