The risk of psychopathology in children with craniosynostosis

Background: The purpose of this study was to assess the prevalence of behavioral and emotional problems in patients with craniosynostosis and to determine the prospective association of a beaten-copper pattern before 18 months of age with behavioral and emotional problems in patients with craniosynostosis. Methods: The authors performed a follow-up study of 115 craniosynostosis patients at the Erasmus Children's University Hospital in Rotterdam. Behavioral and emotional problems were assessed with the Child Behavior Checklist at a mean age of 8 years. The presence of beaten-copper pattern before the age of 18 months was assessed on presurgical radiographs. Analyses were adjusted for intelligence quotient. Results: Whereas craniosynostosis patients with intelligence quotients of 85 or greater did not differ from children in the normal group, craniosynostosis patients with intelligence quotients less than 85 had a higher risk of behavioral and emotional problems. However, these results were comparable to the findings of other studies assessing psychopathology in children with lower intelligence levels. Type of craniosynostosis (single suture versus complex) and a beaten-copper pattern before the age of 18 months did not affect the risk for behavioral and emotional problems in children with craniosynostosis. Conclusion: When intelligence is taken into account, craniosynostosis is not associated with an increased risk of behavioral and emotional problems, nor is type of craniosynostosis or a beaten-copper pattern before the age of 18 months. Copyright © 2009 by the American Society of Plastic Surgeons.