Depressive Symptoms and Behavioral Manifestations in Children and Adolescents with Cerebral Palsy: A Parent-Child Perspective Study

Individuals with cerebral palsy (CP) often exhibit mental health problems, including depressive symptoms. This study investigated self-reported depressive symptoms in children and adolescents with and without CP and associated factors. Herein, 52 and 38 children and adolescents with and without CP were enrolled in the CP and typically developing (TD) groups. Depressive symptoms were assessed using the Birleson Depression Self-Rating Scale for Children. Parents of the participants completed the Strengths and Difficulties Questionnaire. Self-reported depressive symptoms were more severe in the CP group than in the TD group, which was primarily attributed to declining activities and enjoyment in daily life. Depressive symptoms in the CP group were not correlated with age, the severity of CP, or parent-reported behavioral features. However, in the overall cohort, the cluster with high levels of depressive symptoms had significantly higher proportions of individuals with CP and participants with conduct, emotional, and peer problems. Multivariate analyses revealed that only peer problems were associated with increased depressive symptoms. Furthermore, peer problems fully mediated the relationship between the presence of CP and depressive symptoms. Our study suggests that providing opportunities for activities involving social interactions with peers and offering support to enable the enjoyment of such activities from an early age are imperative to prevent an increase in depressive symptoms in children with CP.