Effect of pain on mood affective disorders in adults with cerebral palsy.

This used insurance claims from privately insured adults, which likely reflects a higher-functioning part of the cerebral palsy population, so it may not apply to adults with more severe needs or public insurance. Pain and mood disorders were identified by diagnosis codes, not clinical examination, and both require the person to communicate symptoms, so people with severe cerebral palsy, cognitive impairment, communication impairment, or desensitized chronic pain may be missed. Cerebral palsy severity and subtype were not available; more than 70% had other or unspecified cerebral palsy, so the study could not compare clinical subtypes. Pain was grouped into one yes/no variable and not separated by type, location, or cause, and the authors note that pain diagnosis accuracy in claims may be lower. Medication information, such as pain drugs or anti-epileptic drugs, was not available, so unmeasured confounding remains possible. The follow-up period was relatively short, so some mood disorders may have occurred before pain and not been captured. Mood disorders were based on ICD codes rather than DSM criteria, which may undercount or overcount them. The analysis did not adjust for other mental health disorders, such as anxiety, or substance abuse. Socioeconomic status information was not available. This was observational, so it cannot show that pain causes mood disorders or that treating pain would prevent them.

The supplied text does not include a conflict-of-interest declaration. The publication types indicate research support from NIH extramural and non-U.S. government sources.

Do not conclude that pain causes mood disorders or that treating pain will prevent them. This was an observational claims study, and the authors state that future studies are needed to test whether pain management reduces mood disorder risk.