Psychiatric morbidity in children with epilepsy

Abstract

Epilepsy is a neurological disease which usually starts at childhood and characterized by seizures, or a paroxysmal brain dysfunction due to excessive neuronal discharge with a lifetime prevalence of 1% to 2%. 1 It is the most common neurological disorder worldwide affecting an estimated 50 million people and 80% of affected children are estimated to live in low-income countries. [2][3][4] Children with epilepsy have a high burden of psychiatric and neuro-developmental co-morbidities, and they experience poor long-term psychosocial outcomes even after remission of their epilepsy in adulthood. 1,5 Epilepsy affects physical, mental and behavioral functions and is associated with higher risk of premature death due to traumatic brain injury, status epilepticus, suicide, pneumonia and sudden death, and it accounts for 1.4% of all years of life lost. 3 There is now a general agreement that the incidence of neurobehavioral disorders is higher in patients with epilepsy than in the general population. 6 Co-morbidities in epilepsy can be debilitating, but they are often overlooked. Fortunately, a number of recent efforts are increasing the attention to co-morbidities. 7 Epilepsy has long been considered to be a risk factor for psychosis. 8 There are also increased risks for developing other psychiatric co-morbidities. Though the increased prevalence of behavioral problems has often been documented in children with chronic seizures, several studies have also shown an increased prevalence of behavioral problems in children with new-onset or recent-onset seizures. Mitchell et al. (1994) followed up children for 18 to 30 months. They found that the severity of seizures and the prevalence of behavioral problems remained relatively stable over time. 9 The aim of this study was to report the psychiatric co-morbidities among the children with epilepsy at a tertiary care hospital in Bangladesh. Materials and methodsThis cross sectional study was conducted during the period SummarySuffering from psychiatric illness is relatively common in epilepsy. There is now general agreement that incidence of neuro-behavioral disorders is higher in patients with epilepsy. The objective of the study was to find out the proportion of psychiatric disorders among the children suffering from epilepsy. It was a cross sectional study conducted during the period from July 2009 to June 2011 at the department of Paediatrics in Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. In the study 104 children, aged 5-16 years, having epilepsy were purposively included and patients with febrile seizure were excluded. Data were collected through face-to-face interview using a semistructured questionnaire and diagnosis of psychiatric disorders was assigned according to the Diagnostic and Statistical Manual of Mental Disorders, 4 th edition, text-revision (DSM-IV-TR). The results showed that among all patients 56.7% were male and 43.3% were female. Most of them (80.8%) were within 5-10 years of age. Among them, 57.7% of the cases had associat...

Association of Psychiatric Disorders in Children and Adolescents with Epilepsy in a Tertiary Care Hospital in Bangladesh

“…A study conducted by Ferdous et al included children aged between 5 to 16 years and noted that majority CWE belonged to the age group 5 to 10 years (80.77%). 12 We also found male predominance (64%) in this study, which corroborates the findings of the previous studies conducted in the same region. 12 20 21 However, prevalence studies from other countries showed inconsistent findings with male preponderance, 22 23 24 while others did not find persistent sex differences in the incidence of epilepsy.…”

“…12 We also found male predominance (64%) in this study, which corroborates the findings of the previous studies conducted in the same region. 12 20 21 However, prevalence studies from other countries showed inconsistent findings with male preponderance, 22 23 24 while others did not find persistent sex differences in the incidence of epilepsy. 25 Sex differences in some epilepsy syndrome are well-documented, but the neurobiology behind this difference is still unclear.…”

“…Ferdous et al found that the majority of CWE came from lower socioeconomic conditions. 12 This finding corresponds with findings from other countries. 13 27 As most of the studies were conducted in government-run tertiary care hospitals, where people from lower economic class generally take treatment due to low cost, this finding might not represent the situation in the wider community.…”

“…al (44%), Ferdous et al (57.7%), Dharmadhikari et al (31.2%) and Rehman et al (50%) [11][12][13][14]. The higher prevalence of psychiatric disorders found in this study Sociodemographic characteristics of respondents (n ¼ 136)…”

“…The psychiatric illnesses are higher in CWE in this study than that of previous studies done by Rabin et al (44%), Ferdous et al (57.7%), Dharmadhikari et al (31.2%) and Rehman et al (50%). 11 12 13 14 The higher prevalence of psychiatric disorders found in this study could be due to the use of the diagnostic tool, which encompassed all categories of psychiatric disorders that included neurodevelopmental, emotional, behavioral, and somatic disorders. 15…”