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ABSTRACT: Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL. We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL. Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL. These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.
Epilepsy & Behavior 01/2011; 20(1):89-94. · 2.34 Impact Factor
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ABSTRACT: Depression is frequent, underdiagnosed, and untreated in people with epilepsy. The lack of treatment is partially explained by the concerns over the proconvulsive effects of psychoactive drugs. There are few studies on the effects of selective serotonin reuptake inhibitors (SSRIs) in adults with epilepsy and none in children. The main purpose of the present study was to analyze the impact of SSRIs on the severity and frequency of seizures in children and adolescents with epilepsy and major depressive disorders. In addition, we also evaluated the efficacy of SSRIs in the treatment of depressive symptoms and side effects other than seizure aggravation.
Monthly frequency of seizures was recorded in the 3-6 months preceding the introduction of SSRIs. According to the criteria proposed by A.M. Kanner, A.M. Kozak and M. Frey (Epilepsy Behav 2000;1:100-5), a positive correlation between introduction of SSRIs and seizure worsening should be considered in the following circumstances: (1) occurrence of de novo generalized tonic-clonic (GTC) seizures; (2) recurrence of GTC seizures following a period of at least 1 year without such episodes; and (3) increase in monthly seizure frequency compared with that reported before introduction of SSRIs. Seizure worsening was considered as probably caused by an SSRI when the increase in monthly frequency occurred in a period up to 3 months after the beginning of SSRI use.
Thirty-six children with epilepsy had a depressive disorder. Seizures worsened in two patients. Among this group of patients with depression, all had an improvement in their depressive symptoms. One patient taking fluoxetine had a facial rash and one patient taking sertraline had gastrointestinal disorders. These conditions improved, with total remission, when fluoxetine was replaced with sertraline and vice versa.
In this sample of children and adolescents with epilepsy and depressive disorders, we observed that SSRIs are a good therapeutic option, considering their efficacy in remission of depressive symptoms, their few adverse effects, and their maintenance of satisfactory seizure control. Treatment of depression should be considered relevant in the treatment of patients with epilepsy.
Epilepsy & Behavior 06/2007; 10(3):417-25. · 2.34 Impact Factor
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ABSTRACT: To evaluate quality of life in children and adolescents with acute lymphocytic leukemia (ALL) and juvenile rheumatoid arthritis (JRA).
We administered the Children's Global Assessment Scale (CGAS), the Vineland Adaptative Behavior Scale (VABS) and the Autoquestionnaire qualité de vie enfant imagé (AUQEI) to a sample of 28 children with ALL, 28 children with JRA, and 28 healthy controls, aged 4 to 13 years old, who were diagnosed between 1 and 5 years previously.
Slight differences were found in age between patients with ALL and those with JRA. No significant differences were found in time since diagnosis or in CGAS scores. A significant difference was found in VABS global scores, as well as in VABS communication domain scores. No significant differences were found in VABS daily living skills domain scores between patients with ARJ and healthy controls. No significant differences were found among the groups in VABS socialization domain scores or in AUQEI scores.
In our study, chronically ill children clearly performed worse in adaptative behavior development. Nevertheless, their quality of life was similar to that of healthy controls. Appropriate methods to identify pediatric patients' perception of their illnesses and treatment should be urgently developed.
Anales de Pediatría 07/2003; 58(6):550-5. · 0.77 Impact Factor
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ABSTRACT: It should take into account the pediatric context and the child's development moment to evaluate the quality of life in childhood from a standardized instrument. We present the questionnaire AUQEI validation by its application in 353 children, between 4 and 12 years-old, obtaining a cut off point of 48, internal consistency with a Crombach's alpha of 0.71 and construct validity (r = 0.497). With these psychometrical qualities, the scale shows its importance as a diagnostic tool.
Arquivos de Neuro-Psiquiatria 04/2000; 58(1):119-27. · 0.72 Impact Factor
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ABSTRACT: Through the presentation of four facial expressions' illustrations, we evaluate the capacity of autistic children recognition, comparing with normal intelligence children and adults. The comparison of results was accomplished through the qui-square test. The differences observed were significant, showing that a disturbance of the facial expressions' perception is present in autistic children, and that it interferes directly in the social relationships.
Arquivos de Neuro-Psiquiatria 01/2000; 57(4):944-9. · 0.72 Impact Factor
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ABSTRACT: This study aimed to translate, to adapt and to validate the scale of autistic traits (ATA) developed by Ballabriga et al. in Barcelona, by the analysis of 31 patients with mental deficiency and 30 patients with autism, according to the DSM-IV criteria. The "cut off point" found was 15 (p = 0.05); the reliability coefficient was 0.27; the construct validity showed low agreement (kappa = 0.04) and the internal validity was 100%, with all evaluated patients having their clinical diagnosis confirmed through the scale application. The correlation index was 0.42, showing that it is specific for autism. The scale presents discrimination capacity and internal consistency, and the Cronbach's alpha was 0.71. We consider that achieved results show that the scale is reliable to be used in our population.
Arquivos de Neuro-Psiquiatria 04/1999; 57(1):23-9. · 0.72 Impact Factor
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ABSTRACT: ObjectiveDepression is frequent, underdiagnosed, and untreated in people with epilepsy. The lack of treatment is partially explained by the concerns over the proconvulsive effects of psychoactive drugs. There are few studies on the effects of selective serotonin reuptake inhibitors (SSRIs) in adults with epilepsy and none in children. The main purpose of the present study was to analyze the impact of SSRIs on the severity and frequency of seizures in children and adolescents with epilepsy and major depressive disorders. In addition, we also evaluated the efficacy of SSRIs in the treatment of depressive symptoms and side effects other than seizure aggravation.MethodsMonthly frequency of seizures was recorded in the 3–6 months preceding the introduction of SSRIs. According to the criteria proposed by A.M. Kanner, A.M. Kozak and M. Frey (Epilepsy Behav 2000;1:100–5), a positive correlation between introduction of SSRIs and seizure worsening should be considered in the following circumstances: (1) occurrence of de novo generalized tonic–clonic (GTC) seizures; (2) recurrence of GTC seizures following a period of at least 1 year without such episodes; and (3) increase in monthly seizure frequency compared with that reported before introduction of SSRIs. Seizure worsening was considered as probably caused by an SSRI when the increase in monthly frequency occurred in a period up to 3 months after the beginning of SSRI use.ResultsThirty-six children with epilepsy had a depressive disorder. Seizures worsened in two patients. Among this group of patients with depression, all had an improvement in their depressive symptoms. One patient taking fluoxetine had a facial rash and one patient taking sertraline had gastrointestinal disorders. These conditions improved, with total remission, when fluoxetine was replaced with sertraline and vice versa.ConclusionIn this sample of children and adolescents with epilepsy and depressive disorders, we observed that SSRIs are a good therapeutic option, considering their efficacy in remission of depressive symptoms, their few adverse effects, and their maintenance of satisfactory seizure control. Treatment of depression should be considered relevant in the treatment of patients with epilepsy.
Epilepsy & Behavior.
