Academic journal article East Asian Archives of Psychiatry

Psychiatric and Behavioural Problems in Children and Adolescents with Epilepsy

Academic journal article East Asian Archives of Psychiatry

Psychiatric and Behavioural Problems in Children and Adolescents with Epilepsy

Article excerpt

Introduction

The risk of psychiatric and behavioural disorders is higher in children with epilepsy than in the normal paediatric population as well as in children with other chronic conditions. (1-5) Children with epilepsy are more likely to experience mental health and developmental co-morbidities than the general population. The higher rate of emotional disorders, attention-deficit hyperactivity disorders (ADHD), and autistic spectrum disorders among children with epilepsy has been reported in several studies. (4,6-8) Despite the high prevalence of behavioural and psychiatric problems in children with epilepsy, mental disorders often remain undiagnosed and children's psychiatric needs are largely unmet. (9-11)

Screening of children with epilepsy to identify behavioural and psychiatric disorders may improve their quality of life. (6,12,13) The impact of difficulties on daily life might be greater for adolescents with epilepsy than for those without. (14) Patients with epilepsy, however, constitute a heterogeneous group because of different aetiologies (idiopathic or symptomatic) and manifestations (localisation-related or generalised seizures) of their disorder, and some of them might be at a higher risk than others for mental disorders. Therefore, identifying children / adolescents with epilepsy with an increased risk for psychiatric disorders is important in order to provide comprehensive care.

This study aimed to investigate the psychiatric and behavioural symptoms in children / adolescents with epilepsy. We hypothesised that psychiatric and behavioural problems would be more prevalent among children /adolescents with epilepsy than those without, and that children / adolescents with symptomatic epilepsy would have more problems than those with idiopathic epilepsy.

Methods

Participants

Children and adolescents with epilepsy were recruited during January 2012 to December 2013 from outpatients referred to Medina Medical Center in Azerbaijan, a primary care facility for children with neurological and psychiatric disorders as well as for general paediatric patients. Medina Medical Center serves children of all socio-economic status and most of the referred patients were residents of Baku city. Individuals were eligible for the study if they were aged 4 to 16 years, and have a confirmed diagnosis of epilepsy or presented with seizure episodes and were suspected of having epilepsy but did not have a definitive diagnosis of epilepsy. Children with febrile convulsions and convulsive syncope were excluded from the study.

Epileptic syndromes were diagnosed according to the 1989 International League Against Epilepsy classification. (15) Patients with epilepsy were divided into the following subgroups:

(1) Idiopathic localisation-related epilepsy (ILE);

(2) Idiopathic generalised epilepsy (IGE);

(3) Symptomatic or cryptogenic epilepsy without severe mental or physical disability (severe mental delay, cerebral palsy, neurodegenerative disorders, etc.) [SE];

(4) Symptomatic epilepsy with severe mental or physical disability (SE+); and

(5) Suspected epilepsy (e.g. patients with only one seizure and normal electroencephalography and neuroimaging) or an undetermined form of epilepsy (undetermined cause or epileptic syndrome) [S/UE].

We used a large community sample as the comparison group, which was drawn from the 1st, 5th, and 10th grades of 3 government schools in Baku city. The students in these schools represent all levels of socio-economic status. There was no indication that the epilepsy and comparison groups differed with regard to socio-economic level.

This study was approved by the Ethics Commission of Azerbaijan Psychiatric Association and written informed consent was obtained prior to the study.

Assessments and Instruments

The Strengths and Difficulties Questionnaire

The Strengths and Difficulties Questionnaire (SDQ) is a screening measure that is brief and easy to administer. …

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