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.
    Full-text · Article · Nov 2015 · Epilepsy & Behavior
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    • "This is a structured diagnostic interview designed to assess current and previous episodes of psychopathology in children and adolescents using DSM-IV criteria (American Psychiatric Association, 2000). The K-SADS-PL has been utilized in several studies of children with epilepsy to identify rates of psychiatric comorbidity including ADHD (Ott et al., 2003; Caplan et al., 2005). The K-SADS-PL is conducted by directly interviewing the parent and the child separately. "
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    ABSTRACT: Objective: To determine correlations of the EEG frequency spectrum with neuropsychological status in children with idiopathic epilepsy. Methods: Forty-six children ages 8-18years old with idiopathic epilepsy were retrospectively identified and analyzed for correlations between EEG spectra and neuropsychological status using multivariate linear regression. In addition, the theta/beta ratio, which has been suggested as a clinically useful EEG marker of attention-deficit hyperactivity disorder (ADHD), and an EEG spike count were calculated for each subject. Results: Neuropsychological status was highly correlated with posterior alpha (8-15Hz) EEG activity in a complex way, with both positive and negative correlations at lower and higher alpha frequency sub-bands for each cognitive task in a pattern that depends on the specific cognitive task. In addition, the theta/beta ratio was a specific but insensitive indicator of ADHD status in children with epilepsy; most children both with and without epilepsy have normal theta/beta ratios. The spike count showed no correlations with neuropsychological status. Conclusions: (1) The alpha rhythm may have at least two sub-bands which serve different purposes. (2) The theta/beta ratio is not a sensitive indicator of ADHD status in children with epilepsy. (3) The EEG frequency spectrum correlates more robustly with neuropsychological status than spike count analysis in children with idiopathic epilepsy. Significance: (1) The role of posterior alpha rhythms in cognition is complex and can be overlooked if EEG spectral resolution is too coarse or if neuropsychological status is assessed too narrowly. (2) ADHD in children with idiopathic epilepsy may involve different mechanisms from those in children without epilepsy. (3) Reliable correlations with neuropsychological status require longer EEG samples when using spike count analysis than when using frequency spectra.
    Full-text · Article · Aug 2015 · Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology
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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.
    Full-text · Article · Aug 2014 · Epilepsy & Behavior
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