Psychiatric symptomatology and family functioning in children and adolescents with spina bifida

The purpose of this study was to (a) examine the occurrence of psychiatric symptomatology in children and adolescents with spina bifida, (b) investiga te the relationship between psychiatric features and aspects of disability, and (c) explore the impact of spina bifida and psychiatric status on famil y functioning. Fifty-four children and adolescents ages 6 to 18 years (M = 12.94, SD = 3.59) were examined. Parents completed the Child Symptom Invent ory (CSI) and the Family Assessment Device (FAD). Using the CSI, a psychiat ric diagnostic screen, 43% of the sample obtained one, and 13% obtained two or more screening cutoff scores reflective of psychiatric diagnoses. The t wo most prevalent diagnostic categories were Attention-Deficit/Hyperactivit y Disorder (33%) and Oppositional Defiant Disorder (13%). The sample as a w hole exhibited elevated levels of clinical symptoms, with internalizing sym ptoms more prominent than externalizing symptoms. No differences in diagnos tic categories or overall symptomatology were found based on age, gender, a mbulation status, or lesion level. Overall symptom counts were positively c orrelated with scales on the FAD reflecting problematic family functioning (.42-.63). Results suggest that psychiatric symptomatology occurs at a high rate in children and youth with spina bifida. Although ADHD was the modal diagnostic category, the sample asa whole exhibited extensive psychiatric s ymptoms independent of specific diagnostic categories. Psychiatric symptoms were also associated with increased problematic functioning in families.