A systematic review of hydrocephalus and psychiatric comorbidities in children and adults with spina bifida.

Spina bifida in children and adults is accompanied by substantial psychiatric comorbidity. Hydrocephalus is a common complication of spina bifida and is associated with functional and cognitive deficits, but the role of hydrocephalus in psychiatric comorbidities of spina bifida is unclear. This systematic review aimed to synthesize current literature investigating the relationship between hydrocephalus and psychiatric comorbidities in children and adults with spina bifida. A PRISMA-compliant literature search was conducted using Embase, Scopus, Ovid MEDLINE, and PsycInfo, yielding 3664 articles. Articles included in this review analyzed the relationship between spina bifida-associated hydrocephalus and comorbid psychiatric diagnoses or symptoms. A final cohort of 8 articles was obtained, with a total sample size of 1860 individuals. Across three studies of children with spina bifida, hydrocephalus was associated with an increased risk of inattention and hyperactivity. However, the five studies investigating the relationship between hydrocephalus and psychiatric comorbidities in adults with spina bifida produced contrasting results. Limitations include a small article sample size for each age group and psychiatric outcome, as well as heterogeneity of sample characteristics and outcome measures. A greater understanding of the association between hydrocephalus and psychiatric comorbidities in spina bifida may facilitate prompt screening and earlier intervention.