Incidence of Comorbidities in Children with Neurodevelopmental Disorders in a University Teaching Hospital, Lagos, Nigeria

Background:

Comorbidities associated with neurodevelopmental disorders in children frequently complicate the course of diagnosis and treatment. These conditions may appear in form of medical, psychiatric or other neurodevelopmental problems occurring at different frequencies in different disorders. In recent times, the term 'comorbidity’ has gained popularity in the field of neuro-paediatrics, with the increasing recognition that many conditions are rarely present in isolation.

Objectives: The present study aims to investigate the occurrence of comorbid conditions in children with neurodevelopmental disorders

Methods: Medical records of the neuro-peadiatric clinic were obtained from the health records department of the Lagos University Teaching Hospital (LUTH) and analyzed using statistical methods. Diagnoses of the disorders were done using the DSM criteria while the diagnostic codes were deciphered using the International Statistical Classification of Diseases & Related Health Problems (ICD).

Results: A total of 845 records were obtained with a male: female sex ratio of 1.3:1 (470 males and 375 females). An incidence of comorbid conditions were observed in 44% of the cases revealing cerebral palsy (CP), Down syndrome (DS), seizure disorder and Autism were the major neurodevelopmental disorders. Cerebral palsy presented with the highest frequency of comorbid conditions of 62.2% followed by autism (57.14%) and DS (55.3%) while seizure disorder had the least incidence of comorbidities (33 %). However, attention deficit hyperactivity disorder (ADHD) was the most prevalent comorbidity associated with autism, CP was the most prevalent in seizure disorder, while developmental delay and convulsions were the most common in DS and CP respectively. Convulsions, developmental delay, speech and language disorder and birth asphyxia were the most common comorbidities taking the four neurodevelopmental disorders taken together.

Conclusions: It is apparent that most neurodevelopmental disorders are closely phenotypically linked as have been strongly suggested that neurodevelopmental disorders lie on a spectrum. Understanding the pattern of the incidence of medical comorbidities would aid better-staged diagnosis and interventions, and also improved epidemiological profiling of the disorders.