TY - JOUR T1 - Psychological problems in children with hemiplegia: a European multicentre survey JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 429 LP - 433 DO - 10.1136/adc.2008.151688 VL - 94 IS - 6 AU - J Parkes AU - M White-Koning AU - N McCullough AU - A Colver Y1 - 2009/06/01 UR - http://adc.bmj.com/content/94/6/429.abstract N2 - Objective: To describe the prevalence and determinants of psychological problems in European children with hemiplegia.Design: Cross-sectional survey.Setting: Home visits in nine European regions by research associates who administered standard questionnaires to parents.Patients: 279 children with hemiplegia aged 8–12 years were recruited from population-based case registers.Outcome measure: Strengths and Difficulties Questionnaire comprising emotion, conduct, hyperactivity, peer problems and prosocial domains. An “impact score” (IS) measures the social and psychological impact of the child’s difficulties.Results: Children with hemiplegia had higher mean scores on the total difficulties score (TDS) compared with a normative sample (p<0.001). 48% and 57% of children, respectively, had borderline–abnormal TDS and IS. Significant, independent associations were observed between intellectual impairment and an increased risk for hyperactivity (odds ratio; OR 8.4, 95% CI 3.4 to 20.8), peer problems (OR 3.1, 95% CI 1.7 to 5.5), psychological and social impact (OR 3.0, 95% CI 1.6 to 5.6) when children with an intellectual quotient (IQ) <50 were compared with those with an IQ >70. Boys had an increased risk for conduct (OR 2.1, 95% CI 1.2 to 3.7) and hyperactivity disorders (OR 2.5, 95% CI 1.4 to 4.6). Poor self-esteem was associated with an increased risk for peer problems (OR 5.8, 95% CI 2.5 to 13.4) and poor prosocial skills (OR 7.5, 95% CI 2.4 to 23.2) compared with those with high self-esteem. Other determinants of psychological adjustment were impaired communication, severe pain and living with a single parent.Conclusions: Many of the psychological problems identified are amenable to treatment. Special attention should be given to those at highest risk of developing psychological difficulties. ER -