Behavior and mental health problems in children with epilepsy and low IQ

Abstract

The purpose of this cross-sectional descriptive study was to describe the particular types of behavioral problems, self-concept, and symptoms of depression experienced by children with both low IQ and epilepsy. Three groups of children (83 males, 81 females; mean age 11 years 10 months, SD 1 year 10 months; age range 9 to 14 years) with epilepsy were compared: (Group 1) Low IQ (<85), n=48, 25 males, 23 females; (Group 2) Middle IQ (85 to 100), n=58, 24 males, 34 females; and (Group 3) High IQ (>100), n=58, 34 males, 24 females. The Child Behavior Checklist, Piers-Harris SelfConcept Scale, and Children's Depression Inventory were used to measure behavior, self-concept, and depression respectively. Results indicated that children in the Low IQ group had the most behavioral and mental health problems. Additionally, there were IQ group-by-sex interactions, with females in the Low IQ group being at the highest risk for poor self-concept. Findings suggest that children with both epilepsy and low IQ should be carefully assessed for mental health problems in the clinical setting.Children with chronic epilepsy and children with a low IQ have each been shown to be at increased risk for quality of life problems. Research studies focusing on children with epilepsy and normal IQ, or on children with mental retardation * who do not have epilepsy, show that mental retardation and epilepsy are each independently related to poor quality of life and psychosocial problems (Austin et al. 1994(Austin et al. ,1996Lewis et al. 2000;Sabaz et al. 2001). Because each disorder is associated with such problems it is probable that children with both disorders will experience even greater problems than those with just one of the disorders. Among children with epilepsy, 28 to 38% have some degree of mental retardation (Steffenburg et al. 1996). In addition, there is an unexpectedly high number of children with both epilepsy and low IQ (70 *Correspondence to second author at 1111 Middle Drive, NU 492, Indiana University School of Nursing, Indianapolis, Indiana 46202-5107, USA., joausti@iupui.edu. * UK usage: learning disability. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript to 80) who do not fit the DSM-IV (American Psychiatric Association 1994) criteria for mental retardation (Dodson 2001). On average, the IQ in children with epilepsy is 10 points lower than that of their healthy, age-matched peers (Dodson 2001). Despite the strong relationship between epilepsy and low IQ, only a few studies have addressed the psychosocial and mental health problems of this population.Epidemiological studies of children with mental retardation and epilepsy have established that there are high rates of psychopathology. Rates of psychiatric disorders range from 50 to 59% in children with both epilepsy and mental retardation (Rutter 1989, Steffenburg et al. 1996. The most common psychiatric issues include psychoses, depression attention-deficithyperactivity disorder, socialization problems, aberrant behavior...

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