Risk factors for mental health difficulties in parents of children with cerebral palsy: a systematic review and meta-analysis

Objective: Parents of children with Cerebral Palsy (CP) experience heightened rates of psychological difficulties compared to parents of typically-developing children. There is a lack of understanding of the risk factors for poor parental mental health specific to the early and middle childhood periods. The aim of this review and meta-analysis was to evaluate studies examining risk factors for depression, anxiety and stress in parents of children with CP from birth to 12 years. Method: Searches of CINAHL, Cochrane Library, InformIT, MEDLINE, PROSPERO and PsycINFO were conducted. Twenty-four studies met inclusion criteria for the review and seven for the meta-analysis Results: Results highlighted a range of child, family and social risk factors for poor parental mental health. Overall, the quality of studies included was found to be poor and heterogeneity was high. Meta-analytic procedures identified significant relationships between parental stress and child motor functioning (Fisher’s Z = –0.21; log odd ratio = –.54), cognitive functioning (Fisher’s Z = –.32) and social support available to the parent (Fisher’s Z = –.32). Conclusions: The mental health of parents of children with CP is influenced by child and parent factors, as well as clinical, community and social factors in the early to middle childhood period.