Psychiatric comorbidity in children with new onset epilepsy

TLDR

The study aimed to characterize the distribution, timing, and risk factors of psychiatric comorbidity in children with recent onset epilepsy. The authors recruited 53 children with idiopathic epilepsy (<1 year) and 50 healthy controls, all of whom completed a structured psychiatric diagnostic interview to assess lifetime psychiatric comorbidity. Compared with controls, children with recent onset epilepsy had a higher lifetime prevalence of DSM‑IV Axis I disorders, notably depression (22.6 % vs 4 %), anxiety (35.8 % vs 22 %) and ADHD (26.4 % vs 10 %), with 45 % showing such disorders before their first seizure, indicating possible underlying neurobiological influences independent of seizures or treatment.

Abstract

The aim of this study was to characterize the distribution, timing, and risk factors for psychiatric comorbidity in children with recent onset epilepsy. Children aged 8 to 18 years with recent onset epilepsy (&lt;1 year in duration) of idiopathic etiology ( n =53) and a healthy comparison group ( n =50) underwent a structured psychiatric diagnostic interview to characterize the spectrum of lifetime‐to‐date history of comorbid psychiatric disorder. There was no significant difference between the children with recent onset epilepsy and healthy comparison children in sex (31 males, 22 females vs 23 males, 27 females) or mean age 12.7y [SD 3.3] vs 12.7y [SD 3.2]). Children with recent onset epilepsy exhibited an elevated rate of lifetime‐to‐date Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‐IV) Axis I disorders compared with the comparison group. They showed significantly higher rates of depressive disorders (22.6 vs. 4%, p =0.01), anxiety disorders (35.8 vs 22%, p &lt;0.05), and attention‐deficit‐hyperactivity disorder (26.4 vs 10%, p =0.01) with elevated but less prevalent rates of oppositional defiant and tic disorders. A subset of children with epilepsy (45%) exhibited DSM‐IV Axis I disorders before the first recognized seizure, suggesting the potential influence of antecedent neurobiological factors that remain to be identified. The increased prevalence of psychiatric comorbidity antedating epilepsy onset may be consistent with the presence of underlying neurobiological influences independent of seizures, epilepsy syndrome, and medication treatment.