NEW YORK (Reuters Health) – Children with exotropia type strabismus appear to be at increased risk for developing mental illness by young adulthood, according to a report in the November issue of Pediatrics.

Esotropia in childhood, however, does not seem to be associated with mental illness in early adulthood, note Dr. Brian G. Mohney and colleagues, from Mayo Clinic in Rochester, Minnesota.

The results are based on a review of the medical records for 407 patients with childhood strabismus and 407 matched control subjects from Olmsted County, Minnesota.

Through follow-up to a mean age of 17.4 years, 41.3% of strabismus patients and 30.7% of controls were diagnosed with a mental illness.

Further analysis showed that children with exotropia were 3.1-times more likely to develop a mental illness than their peers without strabismus through a mean age of 20.3 years. Children with esotropia, as noted, were no more likely than controls to develop mental illness.

Intermittent strabismus was associated significant psychiatric morbidity, the report indicates. Compared with controls, subjects with intermittent strabismus had significantly more mental health disorders, more mental health ER visits or hospitalizations, and were at greater risk for suicidal or homicidal ideation.

“Why exotropia and not esotropia would be associated with the development of mental illness by early adulthood is unclear,” the authors note. “Ocular misalignment would seem to have similar effects on individuals with strabismus regardless of whether it is esotropic or exotropic.”

They add that “hereditary is a more likely basis for any association between exotropia and mental illness.”

Reference:
Pediatrics 2008;122:1033-1038.