Abstracts

Rationale: Children with epilepsy are at elevated risk for behavioral, emotional, and cognitive comorbidities that can complicate epilepsy management. Such comorbidities can be premorbid or secondary to epilepsy (i.e., seizures, medication side effects) and likely have both psychosocial and neurobiological underpinnings. Few studies have outlined when health care providers should screen for these comorbidities and initiate referrals for psychological treatment (e.g., at diagnosis versus when parents identify psychological difficulties). Screening for psychological comorbidities is especially salient for children with epilepsy taking anti-epileptic medications because they are at a two-fold risk for suicidality. The purpose of the current study was to identify whether the psychological profile of children newly diagnosed with epilepsy significantly differed from the profile of children with chronic epilepsy diagnoses. We hypothesized that children with longer epilepsy duration would have greater psychological impairments compared to children newly diagnosed with epilepsy.Methods: Secondary data analysis was conducted from two large studies conducted at outpatient tertiary epilepsy clinics using parent report of the Behavioral Assessment Scale for Children-Second Edition (BASC-2). The final sample consisted of 172 children 2-17 years of age diagnosed with epilepsy. Mean age of the sample was 10.2 years, 73% were Caucasian, and 47% were female. Most children were diagnosed with localization-related epilepsy (63.9%, generalized 25.1%, unclassified 10.9%) and the mean time since diagnosis was 3 years. The sample was dichotomized into two groups based on time since diagnosis: new diagnosis (onset < 1 year; 60.5%) versus chronic (onset > 1 year; 39.5%). Results: A consistent trend for greater psychological impairment and poor adaptive functioning was identified for children with chronic epilepsy: internalizing symptoms (t (163)=-2.1, p <0.05); behavioral symptoms (t (104)=-2.8, p <0.05); depressive symptoms (t (97)=-3.7, p <0.001); anxiety symptoms (t (164)=-2.3, p <0.05); withdrawal (t (102)=-3.0, p <0.01); activities of daily living (t (110)=2.5, p <0.05). Children with chronic epilepsy were reported to have significantly higher internalizing symptoms, behavior problems, depression, anxiety, and withdrawal compared to the newly diagnosed children (See Table 1). Children newly diagnosed with epilepsy were reported to have better adaptive-behavior skills compared to children with chronic epilepsy. Conclusions: Consistent with our hypothesis, children managing epilepsy for greater than one year were reported to have worse psychological symptomatology, with the strongest finding in the area of depressive symptoms. Because psychological comorbidities have been shown to compromise disease management, there is a need for systematic screening of these comorbidities early in the course of the disease to prevent significant impairments in child functioning. Given current findings, a particular need for depression screening may be warranted.