Epilepsy Linked with Psychiatric Symptoms in Children

School-age children with epilepsy are significantly more likely to have psychiatric symptoms than are their peers who did not have epilepsy a large Norwegian population-based study shows. The latest study confirms previous findings that identified the same association, according to the authors.

The results "provide further support regarding the high prevalence of psychiatric disorders in the epilepsy population," with multiple risk factors "contributing in a complex picture, also influenced by gender differences," concluded Dr. Kristin Å. Alfstad of the National Centre for Epilepsy at Oslo University Hospital and her colleagues.

Identifying high-risk groups "may help clinicians and provide the possibility for implementing interventions to prevent more serious problems from arising," they wrote in the study, which appeared online March 25 in Epilepsia (doi:10.1111/j.1528-1167.2011.03038.x).

Their findings are based on an analysis of parent responses in a health profile questionnaire completed in 2002 by almost 15,000 students aged 8-13 years and their parents living in a socioeconomically diverse area outside of Oslo. Questions included those pertaining to emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems.

The parents of 111 children reported their child as having or having had epilepsy. Among the 110 children (64 boys and 46 girls) with epilepsy whose questionnaires were completed, 38% had psychiatric symptoms, compared with 17% of the rest of the group, a statistically significant difference. The difference was evident in four areas: emotional problems, conduct problems, hyperactivity/inattention, and peer relationship problems. Emotional problems were more common among the girls, while problems with peer relationships and hyperactivity/inattention were more common among the boys.

In addition to epilepsy, low socioeconomic status was associated with psychiatric problems in the children, but with differences depending on gender: For example, when compared with the controls, the risk of having psychiatric symptoms was fourfold greater among the girls with epilepsy and about twofold greater among the boys with epilepsy; both significant differences. But in boys, the magnitude of the effects of low socioeconomic status on the risk of psychiatric symptoms was similar to that of having epilepsy. This was not seen in girls, for reasons the authors said were unclear, but might have been related to female adolescents having more negative attitudes toward having epilepsy than did male adolescents.

Referring to a 2003 large population-based study that found a 37% rate of psychopathology among children with epilepsy (Dev. Med. Child Neurol. 2003;45: 292-5) and a study published in 2006 (Epilepsy Behav. 2006;9:286-92) that also found a "comparable rate: Among children aged 13-16 years, "the current findings confirm the psychiatric comorbidity of epilepsy," the authors wrote.

More large-scale population-based studies that provide more specific data on epilepsy and possibly validating the psychiatric diagnosis "are needed to explore these problems further," and to study the link between psychopathology, gender, and age, they added.

"Multiple risk factors contribute to the high prevalence of psychiatric symptoms, differently in boys and girls, it seems," Dr. Alfstad said in a statement issued by the publisher of Epilepsia. "Identifying high-risk groups may help clinicians who can implement interventions that prevent more serious psychiatric problems."

The authors of the study had no disclosures related to the article. The study was financed by the National Centre for Epilepsy.