Abstracts

Rationale: Pediatric epilepsy patients are at greater risk for psychiatric comorbities including anxiety, depression and behavior disorders, than children in the general population (Jones et al, 2007). Despite the prevalence of these disorders, little is understood about the onset of the psychiatric symptoms (Rutter et al., 1970; Caplan et al. 2005) and systematic screening or assessment for these disorders is not standard practice. This study sought to provide insight into the frequency of psychiatric symptoms at onset of epilepsy and the tools utilized in this assessment in Minnesota Epilepsy Group's New Onset Pediatric Epilepsy clinic (NOPE). Methods: 91 Pediatric patients (43 female) presented to NOPE within 8 weeks of epilepsy diagnosis for multidisciplinary assessment including: psychological, neuropsychological and medical evaluations. Of this sample, 53 patients aged 7-18, completed psychological evaluations including: semi-structured psychiatric interview of parent and child and completion of screening measures: The Strengths and Difficulties Questionnaire (SDQ) and The Revised Children's Anxiety and Depression Scale (RCADS) parent and child. Patients were broken into two groups by age: 7-11 (group 1), and 11-18 (group 2). Frequencies of diagnoses at onset were computed. Chi-square and T-tests were utilized when comparing screening measures to results from interview and parent and child self-report. Results: Group 1 (31), based on interview, psychiatric diagnoses: 10% behavior disorders, 23% anxiety disorders, and 13% depressive disorders. SDQ parental responses were not correlated with diagnoses found on clinical interview. Parental report on the RCADS panic (r=.77, p< .04) and obsessive compulsive symptom (r=.89, p < .007) scores were associated with their child's scores but not for other symptoms of anxiety or depression. Group 2 (22), based on interview psychiatric diagnoses: 9% behavior disorders, 36% anxiety disorders, 27% depressive disorders. SDQ parental responses were not correlated with diagnoses found on clinical interview for this group either. Parental report on the RCADS separation anxiety (r=.67, p < .02), generalized anxiety (r=.71, p < .01), depression (r=.76, p < .007) and total anxiety and depression (r=.69, p < .02) scores were positively correlated with their child's scores on the same scales. Conclusions: Consistent with prior studies, pediatric patients with new onset epilepsy psychiatric diagnoses present at time of onset. Screening measures were sensitive to some of the symptoms found in clinical interview but not all for both groups. For those children aged 7-11, the screening measures were only sensitive to panic and OCD. These screeners, while sensitive for some of the more obvious or disruptive symptoms, may not be sensitive to more subtle or internalized difficulties, especially for those youth aged 7-11. This speaks to the importance of considering how to best screen and assess for psychiatric comorbidities in children with epilepsy and supports the need for comprehensive early assessment. Funding: NA