Abstracts

Pediatric epilepsy patients are at risk for cognitive and mental health problems. Previously, we found suicidal ideation (SI) was more prevalent in hospitalized pediatric patients with psychogenic nonepileptic seizures (PNES) or both PNES and epileptic seizures (MIX) than those with epileptic seizures alone (ES). Currently, our objective is to describe the occurrence of SI as it relates to cognitive functioning, age, and seizure diagnosis in a sample of pediatric epilepsy patients., Records of 162 children admitted to an inpatient epilepsy unit from 9/99-4/06 for video-EEG monitoring were reviewed. Inclusion criteria included evaluation by a psychologist during the hospitalization, diagnosis of ES, PNES or MIX by a neurologist, and IQ data obtained from within 5 years of the hospitalization. Those with IQ below 40 and those with physiologic nonepileptic events were excluded. All epileptic seizure types were grouped together. Data were analyzed using T-Tests for Independent Measures, ANOVAs, Chi-Squares, and Partial Correlations., 47% of the sample was male. 125 had ES, 20 had PNESs, and 17 had MIX. Gender was equally distributed across seizure groups. ANOVA indicated those with ES were younger (mean=12 yrs; p[lt].01) than those with MIX (mean=14 yrs) and IQs were similar across the three seizure groups (ES mean=79, PNES mean=89, and MIX mean=80). 20% of the sample reported SI. This included 18% of ES (N=23), 24% of MIX (N=4), and 30% of PNES (N=6). Chi-square analyses showed a non-significant but clear trend toward higher SI in those with PNES/MIX than ES. T-Tests showed those with SI were older (mean=13 yrs) and with higher IQ (mean=87) than those without SI (mean age=12 yrs, p[lt].05; mean IQ=79, p[lt].01). Correlations confirmed the relationship between SI and IQ (p[lt].01) and between SI and age (p[lt].05). However, age and seizure group were also significantly correlated (p[lt].01). A partial correlation holding the seizure group constant eliminated significance from the age-SI relationship., In this selective sample, IQ was related to SI, with IQs closer to the average range showing higher occurrence of SI. A trend of higher SI in PNES/MIX was notable, similar to our previous study that indicated a robust relationship between SI and PNES/MIX in a larger sample. Taken together, these results suggest the presence of PNES and an average IQ may increase risk for SI in pediatric epilepsy patients. This study is limited by patient selection factors. Nonetheless, this report represents progress towards determining key factors in identifying pediatric epilepsy patients at highest risk for SI. Further study of this important issue is clearly warranted.,