Review: Psychopathology in childhood epilepsy

Abstract

Background Population‐based studies of psychopathology are important in childhood epilepsy given that there is a spectrum of severity with regard to the impact of epilepsy and associated behavioural/psychiatric difficulties. Method Population‐based studies in childhood epilepsy which have focused on global measures of psychopathology and rates of specific behavioural and psychiatric disorders were reviewed with respect to prevalence of disorders and possible correlates of difficulties. Clinic‐based studies and meta‐analyses were reviewed where they added to an understanding of the correlates or treatment of psychopathology in childhood epilepsy. The systematic review methodology was based on a search of PubMed from January 1980 to June 2011. Results Children with epilepsy are at significantly higher risk for a range of behavioural and psychiatric disorders including attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depressive and anxiety disorders. Available evidence suggests that these difficulties are under‐recognised and there have been few studies focussing on interventions to treat these behavioural and psychiatric issues in childhood epilepsy. Conclusion Population‐based studies suggest high rates of psychopathology in childhood epilepsy. As a result children with epilepsy need close monitoring with regard to the presence of behavioural difficulties. There is a need for studies on how such difficulties can be best managed so that affected children and their families can maximise their quality of life.

Psychological and Social Impact of Epilepsy: Pediatric and Adolescent Review

“…Multiple studies confirm higher rates of psychopathology and poor psychological adjustment associated with childhood epilepsy, [6][7][8] with estimates of behavioral difficulties as high as 4.8 times the general population and 2.5 times compared with other chronic diseases, 9,10 which are often associated with formal psychiatric diagnoses. 11 Seizure variables, however, are not predictive of specific diagnoses.…”

“…11 Seizure variables, however, are not predictive of specific diagnoses. 12 Because behavioral difficulties often predate the initial diagnosis of epilepsy or initial seizure, 6,[13][14][15][16] they have been characterized as "essential comorbidities, 17 that is, characteristics of the disease and the underlying epileptogenic process rather than being secondarily associated with epilepsy. There are multiple seizure-related factors and epilepsy variables associated with the emergence of comorbidities.…”

Children with epilepsy: the role of the educational psychologist

“…• It has been suggested that behavioural checklists that are intended to identify difficulties with attention falsely categorise absence seizures as difficulties such as inattention (Wright, 2009; but see Gleissner et al, 2008). An expert clinical interview and observation should usually separate absence seizures with a clear onset that interrupts an activity from contingent diversion of attention and non-specific daydreaming (Reilly, Kent, & Neville, 2012). • It is important to get information from both teachers and parents on the manifestation of ADHD symptoms as teachers and parents may differ significantly with regard to identification of at-risk children with epilepsy (Sherman, Brooks, Akdag, Connolly, & Wiebe, 2010).…”

Mental health problems in children with uncomplicated epilepsy; relation with parental anxiety

“…Children with epilepsy are at significantly higher risk for a range of behavioral and psychiatric disorders including attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depressive and anxiety disorders. Although psychiatric disorders are frequently seen in patients with epilepsy, these disorders usually have been undiagnosed or untreated [3][4][5][6][7] . It has been found that at most only one third of the patients with mental disorders receive psychiatric treatment 6,7 .…”

“…There are many recent studies on quality of life of the children with epilepsy and their parents' 4,[8][9][10][11][12] . Studies to address the behavioral/psychiatric problems often associated with childhood epilepsy and its effects on parent's anxiety are lacking 3 . In this study, we aimed; to determine what proportion of children with epilepsy, who had previously unidentified mental health problems, were found to have such problems on reassessment to compare mental health problems and parental anxiety in children with and without epilepsy.…”