Summary: Purpose:We assessed rates of symptoms of anxiety and depression among pediatric patients with epilepsy.Methods: We administered the Revised Child Manifest Anxiety Scale (RCMAS), and Child Depression Inventory (CDI) to 44 epilepsy patients aged 7-18 years (mean age 12.4 years). Demographic, socioeconomic, and epilepsy-related information was examined in relation to depression and anxiety scores.Results: No patients had been previously identified to have depression or anxiety. However, 26% had significantly increased depression scores and 16% met critieria for significant anxiety symptomatology. Conclusions: Symptoms of depression and anxiety are common among pediatric patients with epilepsy and appear to be overlooked by care providafs. Key Words: AnxietyDepression-Epilepsy-Seizures-Pediatric.Many controversial studies suggest that patients with epilepsy are at high risk for psychiatric disturbances (1-3) including depression (43) and anxiety (6-8). Most such studies are based on adults; there are far fewer studies of psychiatric symptoms in children and adolescents with seizures. Although depression in childhood has been reported to occur with administration of barbiturates (9), very little is known about overall rates and determinants of depression and anxiety in pediatric patients with epilepsy.Rutter et al. (10) reported psychiatric disturbances in as many as 33% of children with epilepsy but did not specifically delineate affective disorders. Hoare (1 1) noted higher rates of behavioral difficulties in children with epilepsy than in children with diabetes mellitus, but did not determine rates of anxiety and depression. The present study was therefore designed to (a) determine the degree to which the affective disorders (depression and anxiety) had been detected and treated in previous clinical care, (b) determine the frequency of depressive and anxiety-related symptoms among children and adolescents with epilepsy at present, and (c) examine the relationship between self-reported anxiety and depression symptoms with demographic and seizure-related factors. METHODSInclusion and exclusion criteria were as follows: Study entry was offered consecutively to outpatients (aged 7-18 years) with epilepsy (defined as recurrent unprovoked seizures) attending the Pediatric Neurology Department at the University at Stony Brook. Patients with mental retardation were excluded. Patients and their parents completed several self-report measures that examined the following variables:1. Demograptiic variables. Patient ages and sex were recorded. Ages were divided into groups aged 7-12 and 13-18 years. For each child, 1 parent completed the Hollingshead Index, a measure of socioeconomic status (SES) which contains questions about family income, marital and occupational status, and education (12). Scores from the Hollingshead Index were divided into scores of ~2 9 , 2 9 4 8 , and >48 to define lower, middle, and upper SES groups.

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These results show significant HSCT-associated morbidity and mortality in early infantile Krabbe disease and raise questions about its efficacy when performed in newborns diagnosed through newborn screening. The unanticipated identification of "at risk" children introduces unique ethical and medicolegal issues. New York's experience raises questions about the risks, benefits, and practicality of screening newborns for Krabbe disease. It is imperative that objective assessments be made on an ongoing basis as additional states begin screening for this disorder.Genet Med 18 12, 1235-1243.

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