Psychiatric disorders and suicidal behavior in neurotypical young adults with childhood‐onset epilepsy

Abstract

OBJECTIVES We examined the association between lifetime, current history of psychiatric disorders, suicidal thoughts and behaviors with childhood-onset epilepsies in a community-based cohort of young adults. METHODS Cases were neurotypical (normal neurological, cognitive, and imaging exams and no evidence of a brain insult responsible for the epilepsy) young adults with childhood-onset epilepsy followed since the onset of their epilepsy approximately 15 years earlier and recruited as part of a community-based study. They were compared to two different control groups, siblings and external controls from the National Comorbidity Survey-Replication (NCS-R). The Diagnostic Interview Survey assessed lifetime and current DSM-IV-TR diagnoses of mood disorders and anxiety disorders. Suicidal thoughts and suicide attempt were assessed using the Diagnostic Interview Survey for Children-IV and the Diagnostic Interview Survey. RESULTS Two hundred fifty-seven cases and 134 sibling controls participated in the DIS portion of the young adult assessment. Comparing cases both to their sibling controls and to the controls drawn from the NCS-R, we did not find any evidence to suggest a higher prevalence of lifetime and current mood or anxiety disorders, suicidal thoughts and suicide attempt in young adults with childhood-onset epilepsies. SIGNIFICANCE Our findings, from a community-based sample of neurotypical young adults, do not suggest a substantial or lasting association between childhood epilepsy and psychiatric disorders and suicidal behavior.

Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta‐analysis

“…Of the 16 studies that reported associations between childhood chronic physical illness and anxiety, ten studies used a general (unspecified) measure of anxiety (Alwash, Hussein, & Matloub, ; Baldin, Hesdorffer, Caplan, & Berg, ; Ferro et al., ; Gianinazzi et al., ; Kremer, Schieber, Metzler, Schuster, & Erim, ; Ly et al., ; Michel, Rebholz, von der Weid, Bergstraesser, & Kuehni, ; Muller, Hess, & Hager, ; Servitzoglou, Papadatou, Tsiantis, & Vasilatou‐Kosmidis, ; Zeltzer et al., ), and three studies focused on PTSD (Brown, Madan‐Swain, & Lambert, ; Kamibeppu et al., ; Schwartz & Drotar, ). Two studies reported the associations between childhood chronic illness and PTSD as well as general anxiety (Kazak et al., ; Seitz et al., ).…”

“…A total of 528 participants with childhood‐onset epilepsy and 440 physically healthy controls took part in four studies (Alwash et al., ; Baca et al., ; Baldin et al., ; Kokkonen et al., ). Three studies reported the mean age of participants: 22.36 years for individuals with epilepsy and 22.5 years for healthy controls.…”

Psychiatric and behavioral comorbidities in epilepsy: A critical reappraisal

“…Baldin compared levels of lifetime and current mood disorders and history of suicidal ideations and attempts in young adult cases prospectively followed since the onset of epilepsy in childhood and compared their responses to those of their sibling controls as well as to a populationbased sample of controls. 46 The self-reported Diagnostic Interview Schedule (DIS) was used for these purposes. No evidence of increased current or lifetime psychiatric difficulties was found in cases compared to either control group.…”

Social outcomes of young adults with childhood‐onset epilepsy: A case‐sibling‐control study

“…Participants were followed prospectively until study conclusion in January of 2014; details of methods, recruitment and follow-up procedures have been previously described. 23–26 Reassessment protocols that included evaluation of social outcomes were conducted at 9- (2002–2006) and 15- (2008–2014) years after recruitment into the study; the 15-year (or young adult) follow-up included assessment of 361 cases (59% of initial cases) with epilepsy, including 291 with uncomplicated and 70 with complicated epilepsy presentations (Figure 1). At the 15-year assessment, siblings within 3 years of age of cases who did not have seizures or a neurological disability served as controls (N=173).…”