Depression and Anxiety Disorders in Pediatric Epilepsy

Division of Adult Psychiatry, University of California, Los Angeles, Los Ángeles, California, United States
Epilepsia (Impact Factor: 4.57). 06/2005; 46(5):720-30. DOI: 10.1111/j.1528-1167.2005.43604.x
Source: PubMed


This study examined affective disorders, anxiety disorders, and suicidality in children with epilepsy and their association with seizure-related, cognitive, linguistic, family history, social competence, and demographic variables.
A structured psychiatric interview, mood self-report scales, as well as cognitive and language testing were administered to 100 children with complex partial seizures (CPSs), 71 children with childhood absence epilepsy (CAE), and 93 normal children, aged 5 to 16 years. Parents provided behavioral information on each child through a structured psychiatric interview and behavior checklist.
Significantly more patients had affective and anxiety disorder diagnoses (33%) as well as suicidal ideation (20%) than did the normal group, but none had made a suicide attempt. Anxiety disorder was the most frequent diagnosis among the patients with a diagnosis of affective or anxiety disorders, and combined affective/anxiety and disruptive disorder diagnoses, in those with suicidal ideation. Only 33% received some form of mental health service. Age, verbal IQ, school problems, and seizure type were related to the presence of a diagnosis of affective or anxiety disorder, and duration of illness, to suicidal ideation.
These findings together with the high rate of unmet mental health underscore the importance of early detection and treatment of anxiety disorders and suicidal ideation children with CPSs and CAE.

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Available from: Rochelle Caplan, Sep 09, 2014
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    • "e l s e v i e r . c o m / l o c a t e / y e b e h depression and anxiety, as given the internalizing nature of symptoms of the conditions, informants such as parents and teachers may not be aware of depressive and anxiety symptoms the children are experiencing [14] [23]. "
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    ABSTRACT: Methods: Children (5-15years) with active epilepsy were screened using the parent-report (n=69) and self-report (n=48) versions of the Spence Children's Anxiety Scale (SCAS) and the self-report version of the Children's Depression Inventory (CDI) (n=48) in a population-based sample. Results: A total of 32.2% of children (self-report) and 15.2% of children (parent-report) scored ≥1 SD above the mean on the SCAS total score. The subscales where most difficulty were reported on parent-report were Physical Injury and Separation Anxiety. There was less variation on self-report. On the CDI, 20.9% of young people scored ≥1 SD above the mean. Children reported significantly more symptoms of anxiety on the SCAS total score and three of the subscales (p<.05). There was a significant effect on the SCAS total score of respondents by seizure type interaction, suggesting higher scores on SCAS for children with generalized seizures on self- but not parent-report. Higher CDI scores were significantly associated with generalized seizures (p>.05). Summary: Symptoms of anxiety were more common based on self-report compared with parent-report. Children with generalized seizures reported more symptoms of depression and anxiety.
    Epilepsy & Behavior 11/2015; 52(Pt A):174-179. DOI:10.1016/j.yebeh.2015.09.004 · 2.26 Impact Factor
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    • "Epilepsy is the most common neurological disorder in children, and its prevalence in childhood is estimated to be 0.05–1% [1] [2]. Children with epilepsy have been reported to have 3–6 times increased risk of comorbid conditions such as depression [3] [4], anxiety [4] [5], and low selfefficacy [6] when compared with the general population [7]. In addition, they are at increased risk of many comorbid health conditions [8], a finding compounded by lower rates of participation in sports activities [9] [10]. "
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    ABSTRACT: Objectives The purposes of the current study were to test the feasibility of exercise therapy for children with benign epilepsy with centrotemporal spikes (BECTS) and to collect pilot data about the impact of exercise therapy on neurocognitive, emotional, and behavioral outcomes. Methods Ten children with BECTS (9.7 ± 1.42 years) participated in a therapeutic exercise program consisting of ten supervised exercise sessions and home-based exercises for five weeks. Electroencephalography (EEG), seizure frequency, and neurocognitive and psychological factors, including attention, executive function, depression, anxiety, behavioral problems, and quality of life, were assessed before and after the exercise program. Results No clinical symptoms were observed to worsen during the study, demonstrating that the exercise therapy was safe and also feasible. After five weeks of exercise therapy, significant improvements in neurocognitive domains such as simple visual and auditory attention, sustained attention, divided attention, psychomotor speed, and inhibition–disinhibition were observed. Furthermore, parent ratings of internalizing behavioral problems and social problems and mood-related well-being from quality of life improved after exercise therapy. Although not statistically significant, trends were noted toward improvement in children's self-reports of negative mood/somatization, parent reports of somatic complaints, and general health on a quality-of-life measure. Conclusions A five-week structured exercise program was successfully implemented, with preliminary data suggesting beneficial impact on neurocognitive and psychobehavioral function. Exercise therapy should be further evaluated as a part of a comprehensive treatment program for children with benign epilepsy.
    Epilepsy & Behavior 08/2014; 37:151–156. DOI:10.1016/j.yebeh.2014.06.017 · 2.26 Impact Factor
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    • "Depression and anxiety disorders are major comorbidities in epilepsy [1] [2] [3] [4] [5] [6]. Several animal models demonstrated that the status epilepticus (SE) observed in epileptic animals induces aggressive, depressive and anxiety-like behaviors [7] [8] [9] [10] [11] [12] [13] [14] supporting the existence of a shared causation of epilepsy and affective disorders. "
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    ABSTRACT: Recent evidence supports a role for the substance P (SP) in the control of anxiety and epilepsy disorders. Aversive stimuli alter SP levels and SP immunoreactivity in limbic regions, suggesting that changes in SP-NK1 receptor signaling may modulate the neuronal excitability involved in seizures and anxiogenesis. The involvement of NK1 receptors of the dorsal hippocampus and lateral septum in the anxiogenic-like effects induced by a single injection of pilocarpine (PILO) was examined in non-convulsive rats evaluated in the elevated plus-maze (EPM). Male Wistar rats were systemically injected with methyl-scopolamine (1mg/kg) followed 30min later by saline or PILO (350mg/kg) and only rats that did not present status epilepticus were used. One month later, vehicle or FK888 (100pmol)-an NK1 receptor antagonist-were infused in the dorsal hippocampus or the lateral septum of the rats and then behaviorally evaluated in the EPM. Previous treatment with PILO decreased the time spent in and the frequency of entries in the open arms of the EPM, besides altering risk-assessment behaviors such as the number of unprotected head-dipping, protected stretch-attend postures and the frequency of open-arms end activity, showing thus a long-lasting anxiogenic-like profile. FK888 did not show any effect per se but inhibited the anxiogenic responses induced by PILO when injected into the dorsal hippocampus, but not into the lateral septum. Our data suggest that SP-NK1 receptor signalling of the dorsal hippocampus is involved in the anxiogenic-like profile induced by PILO in rats evaluated in the EPM test.
    Behavioural brain research 02/2014; 265. DOI:10.1016/j.bbr.2014.01.050 · 3.03 Impact Factor
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