Conference Coverage

Pediatric epilepsy linked to Axis I psychiatric disorders

Key clinical point: Axis I psychiatric disorders in children with recent-onset epilepsy occur at significantly higher rates than in healthy controls and persist at higher levels through 2 years of follow-up.

Major finding: Rates of depression, anxiety, and ADHD in children with epilepsy ranged from 17% to 34%, compared with rates of 3%-16% for the control group (P = .01).

Data source: A prospective, case-control study of 92 children with recent-onset epilepsy and 71 healthy, first-degree cousins matched by age and sex.

Disclosures: The National Institutes of Health supported the research. The investigators declared no conflicts of interest.




SAN DIEGO – Children with recent-onset epilepsy were more than 2.5 more likely to have Axis I psychiatric disorders than were healthy controls in a prospective, case-control study.

“Children with epilepsy have a significant vulnerability to psychiatric comorbidity,” said Jana E. Jones, Ph.D., and her associates at the University of Wisconsin, Madison. “It will be important to study these children over multiple time points in order to begin to understand the trajectory of psychiatric disorders in epilepsy.”

At baseline, 17%-34% of children with epilepsy had depression, anxiety, or attention-deficit hyperactivity disorder (ADHD), compared with 3%-16% of their age- and sex-matched first-degree cousins (P = .01 for all), the researchers found. Two years later, anxiety still occurred significantly more often among patients in the epilepsy group (31% vs. 10% for controls; P< .001), as did ADHD (19% vs. 4%, respectively; P = .01), they said. These differences remained significant for subgroups of children with focal and generalized epilepsy, compared with controls, Dr. Jones reported at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

The prevalence of depression also remained higher in the epilepsy group at 2-year follow-up (8% vs. 3% for controls), but the difference was not statistically significant. Factors such as age of epilepsy onset, duration of seizures, and number of medications did not appear to affect the likelihood of Axis I disorders, the researchers said.

As recently as 2012, little was known about psychiatric comorbidities in children with epilepsy, said the investigators, noting that their study is the first prospective one of 2 years’ duration on the topic.

The study included 163 children aged 8-18 years. At baseline, all 92 children in the epilepsy group had been diagnosed in the past 12 months and had no other neurologic disorders or developmental disabilities. The researchers identified Axis I disorders by using the Schedule for Affective Disorders and Schizophrenia.

The analysis also found that IQ scores for children with epilepsy averaged 100.8 points (standard deviation, 13.7), which was significantly lower than the mean of 108.4 (SD, 11.1) for the control group.

The National Institutes of Health supported the research. The researchers reported no conflicts of interest.

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