Longitudinal trajectories of depression symptoms in children with epilepsy

Abstract

Aim To examine self‐ and proxy‐reported symptoms of depression in children with epilepsy. Method This was a prospective longitudinal cohort study of children with epilepsy. Participants were treated at six Canadian tertiary‐care centers and followed over 28 months with repeated assessments of child self‐reported symptoms of depression using the Children’s Depression Inventory Short‐Form (CDI‐S). Trajectories of symptoms of depression were estimated using linear mixed effects (LME) modeling. Results At baseline, 477 children had complete data (mean age [SD] 11y 5mo [2y 1mo], range 7y 7mo–15y 1mo; 234 females, 243 males). Mean CDI‐S T score at baseline was 45.7 (SD=7.5) and at 28 months was 44.9 (SD=8.2), both were within the ‘average’ range. Results from LME modeling revealed mean raw CDI‐S score of 1.897, corrected for age 10 years (corresponding to T scores slightly below the normed mean of 50), with no significant change over three measurements (slope=–0.113, p=0.135), indicating that CDI‐S scores were stable over 28 months. Children with high initial CDI‐S scores had lower subsequent scores, as demonstrated by the correlation of –0.827 between intercept and slope (p<0.001). Parents reported comparable findings. Interpretation Self‐ and proxy‐reported symptoms of depression were generally low and stable over an extended follow‐up period. Normalization of scores was seen upon repeated assessment, even in children with higher scores of symptoms of depression at one point. These findings speak to the value and importance of repeated assessment over time. What this paper adds In children with epilepsy, self‐ and proxy‐reported symptoms of depression were generally low and stable over 28 months. The trajectory of symptoms of depression was not associated with seizure severity, whether considering the frequency or type of seizures. Parents’ reports of symptoms of depression were comparable to the children’s self‐evaluations.

Depressive Symptoms and Its Correlate Among Children with Epilepsy at Single-center Study in Oman

“…This finding echoes previous research that found strong correlations between focal seizures and comorbid psychiatric disorders, specifically depression 3 , 27 , 28 but there are dissent views. 29 The findings revealed that children ranging from 9–12 years reported more depressive symptoms and females experienced fewer symptoms of depression, however, the associations were insignificant. Our finding that the female gender has lower depressive symptoms appears to contradict previous studies where depressive symptoms are common in females in the general population as well as those with chronic conditions.…”

“… 23 , 24 A prospective longitudinal cohort study of CWE at six Canadian tertiary care centers followed children for over 28 months with repeated assessments using the Children’s Depression Inventory Short-Form. 25 The picture that emerged was stark; depressive symptoms remained persistent and pervasive and independent of age, types, and severity of the seizure. Although there is no study on the outcome of resective surgery among CWE, at least in the adult population, resective surgery initially appears to have kick started improvement in depressive symptoms, the improvement after resective surgery was more robust among those with superior seizure control.…”

Impact of sociodemographic disadvantage on neurobehavioral outcomes in children with newly diagnosed seizures and their unaffected siblings over 36 months

“…The CDI‐2 is a self‐report questionnaire for children and adolescents designed to identify symptoms of depression appropriate for developmental age 55,61 . The CDI‐2 instrument has been utilized extensively in the pediatric epilepsy population 62,63 . The children with seizures completed this measure at B, M18, and M36.…”

“…55,61 The CDI-2 instrument has been utilized extensively in the pediatric epilepsy population. 62,63 The children with seizures completed this measure at B, M18, and M36.…”

The long view of epilepsy and depression in pediatrics

“…Rosic and colleagues do us a great service by taking on this subject, not only in assessing depression, but by doing it repeatedly for 28 months . The sample itself is impressive: 336 children and adolescents completed the study, although the group appeared to be largely heterogeneous.…”